The Grapevine

Brain Fluid Leak: That Could Be Causing A Runny Nose

For five years, Kendra Jackson from Omaha, Nebraska, had suffered from constant headaches and a runny nose. But the problem was far from being a long-lasting cold or a bad case of allergies.  

"Everywhere I went I always had a box of Puffs, always stuffed in my pocket," Jackson said, adding that her runny nose was "like a waterfall, continuously, and then it would run to the back of my throat."

Her symptoms first began after a car accident in 2013 when she hit her head against the dashboard of the car. She went on to experience coughing, sneezing, trouble sleeping, and painful headaches. "I couldn't sleep, I was like a zombie," Jackson recalled, stating that many doctors could only diagnose her with allergy or winter congestion.

But after she was examined by an ENT specialist at Nebraska Medicine, it was found that her brain fluid had been leaking through her nose, causing the loss of nearly half a pint (8 ounces or 237 milliliters) of fluid every day. The condition is known as a cerebrospinal fluid (CSF) rhinorrhea and has been reported to be a result of nonsurgical trauma in 80 percent of cases

CSF or the "brain fluid" resembles a clear liquid and flows under the outer covering (known as the dura) of both the brain and the spinal cord. It serves a number of important functions such as cushioning the brain, maintaining pressure within the eye, and clearing metabolic waste.

A leak can occur when the dura is damaged, according to Dr. Amber Luong, an otolaryngologist from the University of Texas Health Sciences Center. If such leaks are severe and left untreated, the person can risk developing a serious infection.

"The most common cause [of such leaks is] trauma, like a car accident," Dr. Luong said.

However, spontaneous leaks can occur due to increased pressure inside the skull, more likely to happen in the case of overweight people. Dr. Luong added that it is also more common among older people because "it takes some time for that pressure to ultimately erode the bone."

In the case of Jackson, Nebraska Medicine rhinologist Dr. Christie Barnes and neurosurgeon Dr. Dan Surdell used a relatively non-invasive method to operate and fix the source of the leak. 

"We go through the nostrils, through the nose. We use angled cameras, angled instruments to get us up to where we need to go," Dr. Barnes explained. The doctors proceeded to use Jackson's own fatty tissue as a plug to seal the hole from which fluid was spilling out. 

Jackson confirmed she felt better than ever after the procedure, stating that her sleep quality was finally back to normal and her head felt clear for the first time in years. 

"I don't have to carry around the tissue anymore, and I'm getting some sleep," she said.