Man, 20, with constant runny nose discovers his brain was poking out and ‘leaking’

DEALING with a runny nose can feel relentless.

No matter how many tissues you go through, sometimes it just keeps on coming.

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For one 20-year-old man, this was his reality for six years – until doctors discovered the ‘snot’ wasn’t snot at all, but brain fluid leaking from his skull.

The unidentified patient from Syria had been battling a constant runny nose, along with headaches and seizures, ever since a head injury.

What he thought was simply a cold symptom turned out to be cerebrospinal fluid (CSF), which protects the brain and spine. 

He also had a portion of his brain protruding from the top of his nose.

The trouble started after the man was in a car accident six years earlier.

Despite sustaining a head injury which left him suffering headaches, seizures and clear snot constantly streaming from his nose, he chose not to seek medical treatment.

After conducting brain scans, doctors diagnosed the man with traumatic encephalocele – a condition where brain matter escapes through openings in the skull – in this case, the nasal cavity.

Most cases of encephalocele are seen in newborn babies, when a portion of the brain tissue protrudes from part of the skull which hasn’t formed properly.

It occurs in about one in 5,000 births, according to the Fetal Medicine Foundation.

In some cases, an encephalocele can develop after a head or brain injury, and it might not show up until years later, especially if the initial injury wasn’t treated.

Since traumatic encephaloceles are so rare, there aren’t any reliable statistics on how many cases occur each year.

Writing in the Journal of Medical Case Reports, doctors in Syria said 10 to 30 per cent of skull base fractures result in CSF leakage.

This can damage the brain’s blood supply and function since CSF cushions and protects the brain.

Surgery is needed to repair the rupture and seal any openings to prevent further leakage.

In the case of the Syrian patient, the man refused initial treatment for injuries when he was brought to the hospital after his car accident. 

‘A rare and unexpected complication’

More recently, the man was hospitalised and treated in intensive care for meningoencephalitis, a life-threatening brain infection.

During his visit, an MRI revealed a skull-base fracture, which had let part of his brain seep into his nostril.

Doctors recommended surgery to repair the fracture, but the patient refused medical care. 

When he came back for a follow-up two months later, the MRI still showed the same issue, so surgery was recommended again.

This time, the patient agreed, and the neurosurgeon performed an operation to put the tissue and matter that had leaked through his nasal cavity back where it belonged.

The doctor also repaired the damaged brain and used medical-grade cement and glue to reconstruct the base of the skull, which had been fractured.

The patient recovered well and was sent home two days later.

At a follow-up two months later, the MRI showed that the encephalocele was fully closed and any damage caused by the bulging matter had been reversed.

The man also stopped having headaches, a runny nose, and seizures.

Doctors in the case report warned that although a traumatic encephalocele is “a rare and unexpected complication of trauma,” doctors must evaluate patients for it “because of its life-threatening consequences.”