January 19, 2010

Runny Nose Due to Spinal Fluid Leakage and Not Allergies!

Image from Wikipedia
The Washington Post published a story on January 19, 2010 entitled "Doctors changed diagnosis after woman said allergies weren't causing runny nose." In this story, the patient's runny nose from only one side was actually due to a CSF leak (cerebrospinal fluid leakage) and puts her at major risk for meningitis. Unfortunately for this particular patient, the hole through which this fluid was coming out from also had some brain tissue. She required major surgery in order to correct this problem.

An interesting trivia related to CSF leaks is that actor George Clooney suffered one after a blow to the head while filming a torture scene in the 2005 movie "Syriana".

The take-home message is that not all runny noses are due to allergies, especially if it is continuous and only occurs on one side.

Typically, if CSF leak is suspected, a red-top tube is provided to the patient to collect some of this fluid. The specimen is than sent to be tested for beta2-transferrin which is ONLY found in CSF.

A high resolution CT scan of the sinuses and/or temporal bone is also obtained to localize WHERE the abnormal leak is coming from.

What type of surgery is performed utterly depends on where the leak is coming from... if truly sinus in origin, endoscopic sinus surgery is performed. If coming from the bone around the ear, a middle cranial fossa approach to fixing the leak is performed.

Read the story here.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.


Surgical Instruments said...

It is very useful information. I like it very much. It will be help a huge number of people, who have the interest in this field. Keeps it up great work!!!!!.

Anonymous said...

Concerns Having had a removal of a tumour from my Pituitary Gland
in 2006. This operation was successful.repairs to my nostrils sealed
and all was well.Now its 2013. The holes that had been once made by the surgery and sealed have once again opened.I fear this maybe due
to many attempts to clear my blocked noes so that l can use my apnea
machine through the night. There has been effected by congealing blood in the nostril. Which seems strange the blood does not run as you would expect.Other symptoms include a very dry mouth to the point it appears like white floss. Any idears???? This could help.

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