CSF Rhinorrhea Treatment in Dubai

CSF stands for cerebrospinal fluid. It is a clear, colorless fluid that protects and cushions the delicate brain and spinal cord. It is also referred to as brain and spinal cord fluid. The brain and the spinal cord make up the central nervous system. They operate, control, and coordinate everything we do. Hence, cerebrospinal fluid plays a vital role in protecting and nourishing these delicate organs.

The CSF fluid is constantly produced and absorbed. But sometimes, the fluid may leak from the bony enclosures to the surroundings and ooze from the nose and ears. If the leaks are small, the symptoms are barely noticeable, but if they are large, they may cause severe symptoms.

Symptoms of CSF leaks

Symptoms of CSF leak from the brain are:

  • Dizziness
  • Confusion
  • Vision changes
  • Hearing changes
  • Nausea or vomiting
  • Pain in the lower back part of the head
  • Headaches that worsen while standing or jerking and improve when lying down
  • Neck or shoulder pain
  • Ringing ears (tinnitus)
  • Change in cognition or behaviour

The spinal CSF leak is called cranial CSF. The cranial CSF leak symptoms include:

  • Watery drains from the nose or ear 
  • A metallic taste in the mouth
  • Hearing loss
  • Meningitis

What causes CSF leaks?

Cranial CSF leaks from the head may be caused by:

  • A head injury
  • Cerebral shunt malfunction 
  • Increased pressure in the brain
  • Malformations of the inner ear

 

Spinal CSF leaks may be caused by:
  •  Lumbar puncture (spinal tap)
  • An epidural injected in the spine for pain relief during labour and delivery
  • Head or spine injury
  • Bone spurs in the spine
  • Abnormal connections in dura mater and veins 

 

Sometimes CSF leaks may occur due to :

  • Sneezing and coughing

  • Strained bowels

  • Lifting heavy objects

  • Falling

  • Stretching or exercising 

Rhinorrhea Treatment

Diagnosis of CSF leaks

Dr. Peter will examine your medical history and then take a physical examination. He will order the following tests for a detailed diagnosis.

MRI with Gadolinium

It highlights brain or spine abnormalities.

Radioisotope cisternography

It tests CSF pressure in or around the spinal cord.

Myelography

It is considered a standard gold test for diagnosing and locating CSF leaks. It uses fluoroscopy, a CT or MRI scan, and a contrast dye to locate CSF leaks precisely.

Spinal tap (lumbar puncture)

It involves puncturing the spinal column with a thin needle to measure the pressure of CSF inside the spinal column.

Treatment of CSF leaks

Some CSF leaks improve with bed rest alone. Other CSF leaks may need treatment. Those spontaneous cranial CSF leaks require surgery.

Our treatment modules for CSF rhinorrhea treatment in Dubai include:

  • Sealant- A special sealant is used to seal or cover the hole of the CSF leak.
  • Epidural blood patch - Your blood is derived and then injected into the spinal canal. The blood clots and creates a patch, covering CSF leakage.
  • Surgery- Some CSF leaks are corrected only by surgery. The surgery is performed when other treatments don't work, and there are too many CSF leaks. The CSF leak is stitched with muscle or fat grafts (patch).
  • Trans-venous embolization - It is a minimally invasive, catheter-based treatment. It is indicated when CSK leaks cause spontaneous intracranial hypotension. This method glues and shuts the fistula from inside the leaking CSF-venous fistulas.

Post-treatment, Dr. Peter Baptista, the ENT specialist, suggests you take ample bed rest with the following conservative measures,

  • Elevating the head off the bed
  • Taking stool softeners to prevent straining