One woman's chronic 'runny nose' was actually a brain leak—here's what that means

hole can be caused by trauma, such as a head injury, or simply occur spontaneously. The main symptoms, on top of watery drainage from the nose, are vision changes, dizziness, headaches, and hearing loss. The condition is both rare and treatable. 

Dr. Satish Govindaraj, chief of the Division of Rhinology and Sinus Surgery for the Mount Sinai Health System in New York, is one of the leading doctors in the field of CSF leaks. Together with his team at Mount Sinai, he has pioneered a “high resolution CT/MRI fusion technique” that allows doctors to better locate the actual site of the CSF leak.

As someone intimately connected to this subject, Govindaraj doesn’t seem particularly surprised by Jackson’s story. “It can happen in someone who has a history of trauma, such as a motor vehicle accident,” Govindaraj tells Yahoo Lifestyle. “They might have a fracture and they didn’t even know it.” To test for the condition, Govindaraj and his team use a serum that can detect brain fluid. But just because someone has a consistently runny nose doesn’t mean they need this test. 

On top of noting that it’s an “incredibly rare” condition, Govindaraj raises an important distinction about the symptom of watery drainage. “It would be specifically coming from one side,” he says. “It’s extremely rare to have a leak on both sides, so it’s clear drainage from one side that should raise a red flag.” But even if it is coming from one side, that may not be cause for alarm. “If it’s brain fluid, it would be almost like straight water — like the fluid out of a facet,” he says. “It’s not something where someone has allergies they should run to the doctor and check if they have this.”

In terms of what’s actually causing it, Govindaraj likens it to a pressure cooker in need of a release valve. “When the brain fluid pressure builds, it becomes trapped in the skull, so it ends up leaking where the bone is thinnest,” he says, mentioning the part where our smell nerves connect to our brains. “That hole acts as a decompression.” 

Although the leak itself isn’t necessarily dangerous — since the body routinely creates brain fluid — having it exposed to the nasal cavity, which can transport infections, is dangerous. So surgery to plug the hole is recommended immediately. Doing so can bring on more headaches, since the pressure has nowhere to go, but Govindaraj says that’s the next and final step: “We have to manage that pressure.”