Runny Nose Lasting 6 Years Thought to Be a Cold... It Was Flowing from the Brain

20s Syrian Male Story Featured in Academic Journal
'Traumatic Encephalocele' Causes Cerebrospinal Fluid Leakage

The story of a man in his 20s from Syria who had cerebrospinal fluid leaking from his nose for six years after a head injury in a traffic accident has been revealed.

Recently, British media outlets The Sun and Daily Star reported on the story of Mr. A, a man in his 20s from Syria who suffered a head injury in a traffic accident and had nasal discharge for six years. His case was also featured in the clinical case report journal, Medical Case Reports Journal. Six years ago, he was injured in a traffic accident but thought his condition was fine and did not seek treatment. Afterwards, Mr. A suffered from headaches and seizures along with nasal discharge. The constant runny nose interfered with his daily life, but he believed it was just a severe cold.

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Recently, Mr. A was hospitalized and treated for meningitis and underwent magnetic resonance imaging (MRI). The results were shocking. He was diagnosed with traumatic encephalocele, a condition where part of the brain protrudes into the nasal cavity. Traumatic encephalocele occurs when the skull is fractured and brain tissue leaks through the nasal cavity. The fluid he thought was nasal mucus for six years was actually cerebrospinal fluid, which protects the brain and spinal cord.

Syrian medical staff explained, "Cerebrospinal fluid cushions and protects the brain, so leakage can impair blood supply and brain function." Mr. A had been leaking cerebrospinal fluid since the traffic accident because he did not receive initial treatment when transported to the hospital. The attending physician performed surgery to repair the damaged brain by repositioning the tissue that had leaked into the nasal cavity and reconstructing the fractured skull base to stop the cerebrospinal fluid leakage. The surgery outcome was favorable. Two months later, Mr. A no longer experienced headaches or seizures, and the cerebrospinal fluid leakage had stopped.

When cerebrospinal fluid leaks from the nose, clear nasal discharge continuously flows. To distinguish cerebrospinal fluid from nasal mucus, one can apply pressure to the abdomen. Nasal mucus does not increase with abdominal pressure, but cerebrospinal fluid rhinorrhea increases the amount discharged when abdominal pressure is applied. Causes of cerebrospinal fluid leakage from the nose include ▲head trauma ▲spinal injury ▲surgery or examinations on the head and spine ▲epidural injections for pain relief. Symptoms suggesting cerebrospinal fluid leakage include not only nasal discharge but also hypotension, visual disturbances, seizures, tinnitus or hearing loss, loss of smell, and speech difficulties. If these symptoms are suspected, one should avoid blowing the nose, using straws, or blowing air with the mouth. It is also necessary to visit a hospital for computed tomography (CT) or magnetic resonance imaging (MRI) scans.

Treatment methods for cerebrospinal fluid leakage include endoscopic surgery and non-surgical treatments. Endoscopic surgery involves inserting a small camera into the nasal cavity to locate and suture the affected area. Non-surgical treatments mainly involve avoiding heavy lifting, refraining from coughing, sneezing, or nose blowing, and keeping the head elevated 10 to 15 degrees higher than usual to allow the leakage site to heal naturally.