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.