Am I leaking snot or brain fluid?

Cerebrospinal fluid (CSF) rhinorrhea is a condition where the fluid that surrounds the brain leaks into the nose and sinuses. Head trauma, surgery, or even birth defects can make a hole in the membranes that hold this fluid. It then leaks into your nose or ear, causing a watery, runny nose. 

CSF rhinorrhea is rare but not uncommon. This condition can put one at risk for dangerous infections - meningitis and pneumocephalus (air in the cranial cavity). 

Runny Nose or Brain Fluid Leak?

"Rhinorrhea" means "runny nose." But a runny nose with brain fluid in it is different than allergies or a cold. If brain fluid is leaking, one may notice:

• The fluid from nose is watery and clear
• Dripping in the throat
• Drips increase when head is upside down
• Headaches
• A salty or metallic taste in the mouth
• Nasal congestion
• Dizziness
• Ringing in the ears

Having these symptoms may mean that one has CSF rhinorrhea. CT scans may locate the leak. 

Any one with these symptoms ought to call 911 or go to an ER without any delay.

CSF Rhinorrhea Treatment

Sometimes, all one needs is bed rest. In other cases, treatment may be necessary to stop the leak. 

Medications to Reduce Fluid

Medications can help lessen the production of the fluid that surrounds the brain. This

• Reduces the pressure
• Allows the leak to seal on its own

Surgery to Repair the Leak

Advanced surgical methods with Small tools and cameras (endoscopes) allow repair  of tissues deep in the skull without a big, difficult operation.

A specialist may access the leak through the nose. Skin or bone from inside the nose or small pieces of fat from the abdomen may help repair the leak.

Surgery usually requires a hospital stay of 3 to 6 days. 

Author

Paddy Kalish OD, JD and B.Arch