A Rare Condition of Brain Fluid Leaking Due to Pilates? Here’s What You Need to Know

A few years ago, a woman experiencing persistent headaches has eventually discovered the culprit for her suffering: one of her Pilates sessions led to the leaking of the fluid her brain.

The said incident was reported in early 2015. The case report indicated that the brain fluid leak, which later resulted in unbearable headaches, eased when the 42-year-old woman laid down.

Although the doctors were not able to identify the exact part of the leak in the brain, the woman's condition reportedly improved after following weeks of pain relievers and bed rest.

Medical experts identified this rare condition as a cerebrospinal fluid leak or CSF leak. CSF is the transparent liquid surrounding the spinal cord and the brain. And its main function is to supply the brain and the spinal cord with nutrients. At the same time, it cushions the brain inside the skull.

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Symptoms of CSF Leak

Medical reports explain that in some cases, the fluid may leak through the nose or ears, or into any part of the body. Additionally, the CSF in the spine can drip into muscle and connective tissues that surround the spinal column.

Essentially, such leak is a severe condition that can lead to complications like seizures, meningitis, and in the case of the British woman, headaches.

The most common CSF leak symptom, according to the Spinal CSF Leak Foundation, is an upright headache. This means that a particular headache gets worse when the head is in an upright or vertical position, as it is when an individual is seated or standing.

Such headaches typically improve when the patient is lying down. At times, the head's position does not directly impact the headache's severity.

Rather, an individual may feel a headache that gets worse throughout the day. A person experiencing a CSF leak may see watery and clear fluid coming out of his nose or ears when moving his head, especially as the patient bends forward.

In some cases, the CSF could drain the rear of the throat, as well. Other people describe its taste as experience as salty and metallic.

Other symptoms of this condition may also include tinnitus, hearing loss, and changes in vision.

Causes

According to studies in adult individuals, up to 90 percent of all CSF leak occurrences are an outcome of head injuries.

Additionally, it could also be that a blunt force head injury breaks the bones of a person in the face, or on any of the sides of his skull.

Other reasons for such a leak, either in the spine or skull, may also include epidural injection, lumbar puncture, infection, anesthetic injection, brain tumors, and surgery either on or around the skull or spine's base.

Diagnosis

To diagnose a CSF leak, doctors employ several tests.

One of these tests involves placing a sample of the suspected CSF discharge on a piece of paper. Once the fluid gets in contact with the paper, it will separate from an accompanying carrier fluid--either mucus or blood. As a result, it will create two distinctive rings identified as a "target" or a "double-ring sign".

In some cases, a healthcare expert identifies CSF leaks by simply looking at a sample on a piece of gauze or cloth. As it is different from sticky and thick mucus, CSF is typically watery and clear.

When the doctor suspects that the condition is a CSF leak, he may recommend an MRI or CT scan to validate the diagnosis and further locate the leak.

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Treatment

Treating a CSF leak depends on how severe the case is and its identified cause. In some occurrences, doctors turn to conservative therapy, while in some, more invasive procedures are necessary.

For conservative treatments, they primarily focus on the management of such symptoms. These treatments may include bed rest, ensuring hydration at all times, taking prescribed or over-the-counter pain-relief drugs, and receiving invasive treatments, among others.

If the patient is not responsive to any of the conservative treatments mentioned, it may require the more invasive method, like an epidural blood patch, which involves using an individual's own blood to repair and patch tears in the dura mater. Another more invasive approach may involve surgery.

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