Traumatic Spinocutaneous Fistula Following a Stab Wound to the Neck

Here is a case report on a 28-year-old woman presenting to the emergency department after multiple stab wounds to the head, neck, and upper extremities. After wound repairs were complete, the patient was discharged. She was readmitted multiple times with evolving symptoms in the first week. Eight days after the initial incident, she was readmitted once more with positional headache and leakage of clear fluid from a suboccipital scalp stab wound. Her MRI showed a fistulous CSF tract from the dorsal spinal canal to the skin.

Although rare, clinicians should consider the possibility of a traumatic spinocutaneous CSF fistula for patients presenting with positional headaches or clear wound drainage, even days after the initial trauma.