Kendra Jackson had no idea why her nose ran all the time. For years, the Omaha, Nebraska resident lived with headaches as well as general discomfort and inconvenience, blowing and wiping constantly, unable to get a good night’s sleep. “Everywhere I went I always had a box of Puffs, always stuffed in my pocket,” Jackson told KETV Omaha last Friday. Her doctors thought it must be allergies, but it turned out to be a lot more serious.
Convinced that she was living with something more than allergies, Jackson pushed her doctors to investigate more thoroughly. They found she had a cerebrospinal fluid (CSF) leak, which means the liquid that protects the brain and spinal cord from the jostling and jarring of everyday life was literally running out of her nose. CSF is usually confined to the brain and spine, but leaks can occur when the skull or dura mater — the outermost membrane surrounding the brain and spinal cord — gets ruptured. This can happen multiple ways, including head injury, lumbar puncture, and sinus or brain surgery. Leaks can also occur spontaneously in people with genetic disorders that affect connective tissue since their dura maters are already weakened, according to Cedars-Sinai, a Los Angeles-based nonprofit academic healthcare organization.
Unaware of her CSF leak, Jackson experienced headaches along with her nasal drainage, two common symptoms of the condition, according to Johns Hopkins Medicine. People with CSF leaks can also experience tinnitus, visual disturbances, and sometimes even meningitis. Leaks can be hard for doctors to catch, since they may seem like other neurological disorders — or in Jackson’s case, allergies — some imaging techniques like MRI won’t necessarily be able to detect the leak. Because of this, patients might slip under the radar unless they present with symptoms shortly after a medical procedure that could cause a CSF leak, according to the Spinal CSF Leak Foundation. To confirm a case like Jackson’s, doctors often test nasal leakage for beta-2 transferrin, a protein found in CSF.
In Jackson’s case, this seems to be what happened. In 2013, she was involved in a car accident in which her head hit the dashboard. Her runny nose and headaches didn’t start until a couple years later, so doctors failed to make the connection. Fortunately for Jackson, she advocated for her health and eventually doctors figured out what was ailing her. Thanks to surgical advances, the surgery to repair her leak was minimally invasive.
“We go through the nostrils, through the nose,” Nebraska Medicine Rhinologist Dr. Christie Barnes told KETV. “We use angled cameras, angled instruments to get us up to where we need to go.” It’s not exactly clear how much longer she could have lived without detection, but doctors report she was losing a cup of CSF a day, which is about half of the amount adults produce each day.
If left untreated, CSF leaks can lead to meningitis, stroke, and brain infections, all of which can be life-threatening. Now that Jackson’s injury has been repaired, though, doctors expect her to make a full recovery.