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Watery discharge from nose or ear after accident? Don’t take it lightly

Incidence of head injuries is a common occurrence after any road traffic accident or fall from a height but in some cases, this can lead to Cerebrospinal Fluid leak and one can suffer a severe injury without recognising the symptoms. Cerebrospinal Fluid (CSF) is a clear liquid that provides a cushion to the delicate brain, spinal cord and tissue where the formation of a hole or tear in the outermost layer of the membranes can lead to a leak and allow some of the fluid to escape.

Watery discharge from nose or ear after accident? Don’t take it lightly (Photo by Brittany Colette on Unsplash)

In an interview with HT Lifestyle, Dr Rakesh Lalla, Consultant-Neurology at Fortis Hospital in Kalyan, insisted that reduced cerebrospinal fluid due to a leak or other cause, will need immediate intervention by a trained expert and revealed, “The common symptoms are nausea, vomiting, drowsiness and memory disturbance. Some may also develop limb weakness or seizures. Occasionally, a few victims may complain of persistent watery or blood-stained discharge from the nose or ear. This usually occurs if there is a fracture of the skull base, involving a cribriform plate on the roof of the nasal cavity, this is called CSF Rhinorrhoea.”

He highlighted, “Unlike Rhinitis which happens in the common cold, CSF Rhinorrhoea is almost continuous like a leaking tap. It usually happens when the person bends forward, however, while lying down one may feel salty water in the throat. Similarly, due to a fracture of temporal bone one may get CSF leak from ear. Most CSF LEAK headaches are aggravated in upright position but that may not be always true. Instead, a person may experience a severe or moderate headache that worsens throughout the day. Patients with a CSF leak may also notice clear, watery fluid draining from their nose or ears while moving their heads backward.”

Talking about diagnosis and treatment, he siad, “Treatment for a CSF leak depends on the cause and severity. Some leaks could be cured through conservative treatment, while others may require more invasive approaches. It’s important not to ignore it as this may lead to infection in the brain, and cause Meningitis. In case of any of such symptoms, one may see the doctor immediately. Few cases resolve spontaneously or with the use of diuretics. If leaks are massive, one needs to do analysis of the nasal fluid or CT Cisternography. Such leaks might also require surgical repair with the help of a neurosurgeon and ENT surgeon.”

For conservative treatments, he shared that usually, the recovery depends on the severity of the leak where conservative treatments largely focus on managing symptoms and includes the following steps:

  • Bedrest with the head elevated around 30 degrees
  • Avoid sneezing or nose-blowing
  • To avoid straining, use stool softeners
  • Stay hydrated and focus on what you are eating
  • Taking pain relief medication as per doctor’s guidance

In conclusion, if one suffers from a head injury, they should immediately consult an expert to rule out any serious problem.

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