Long Life and Health
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Runny Nose Could Be Brain Fluid!

She thought she just had a runny nose, but a Nebraska woman was actually leaking critical cerebrospinal fluid from her brain through her nose!

Cerebrospinal fluid is a clear, colorless fluid that surrounds and protects the brain and spinal cord. The fluid also helps to remove waste products from the brain and distribute nutrients and other substances throughout the central nervous system.

For over two years, 52-year-old Kendra Jackson of Omaha just thought she had a bad cold.

“When it first started out, I just thought it was my allergies or a runny nose — like the beginning of a fresh cold,” Jackson said.

The coughing, sneezing, and runny nose began 2½ years after Jackson was involved in a serious car accident. She remembers hitting her face against the dashboard, and she has struggled with migraine headaches ever since.

It was in 2015 when Jackson’s runny nose started to worsen considerably.

“When it didn’t go away, I kept going back and forth to the doctors, and they prescribed every kind of medicine you can think of, and my nose just kept on running,” she said.

The doctors she saw told her that she probably had allergies. But in 2018, Jackson went to physicians at Nebraska Medicine and learned the real reason behind her nasal discharge: a cerebrospinal fluid, or CSF leak caused by a small hole in her skull -damage that probably happened during her car accident.

Jackson said she was losing about half a liter of fluid per day.

“She would wake up in the morning after sleeping upright in a chair, and the whole front of her shirt was wet with fluid. It was a lot of fluid,” said Dr. Christie Barnes, a rhinologist at Nebraska Medicine and a lead surgeon on the case.

A physician assistant “astutely recognized right away that this was something different than a runny nose and was consistent with a CSF leak. So we had her collect her fluids and sent it off for evaluation,” Barnes said.

Cerebrospinal fluid is produced continuously in the brain and is normally absorbed into the bloodstream through protrusions in the outer membrane of the brain, called the dura mater.

But in Jackson’s case, a tiny hole in her cribriform plate — a thin bone that separates her cranial and nasal cavities — allowed the fluid to drip into her nose and mouth, resulting in her symptoms.

According to Barnes, this part of the skull is “very thin, less than a potato chip. And it’s one of the most common locations for this type of a CSF leak,” Barnes said.

Depending on the amount of fluid loss, cerebrospinal fluid leaks can be life-threatening. They also place the patient at an increased risk of infections such as meningitis, according to Barnes.

In order to treat Jackson’s condition, physicians at Nebraska Medicine performed a surgery that plugged the hole in her skull using tissue from her nose and abdomen, Barnes said.

“I used tissue from the inside of her nose to plug the leak,” Barnes said. “I also borrowed some abdominal fat; it makes a great plugging agent in this location, so with just a tiny bit of fat, I was able to plug the leak.”

After about a month of recovery post-surgery Jackson was doing fine, and the “runny nose” had stopped. 

Though her condition is rare, Jackson wants people to know that cerebrospinal fluid leaks can occur, particularly after head trauma: “For people who hear my story, if they’re tasting a very salty taste and something’s draining in the back of your throat, it’s probably something other than allergies. So get to the doctor.”

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