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This case study redefines someone’s brain choice.
A woman’s coronavirus test went terribly south after she inexplicably began leaking cerebrospinal fluid (CSF) through her nose, according to a case report.
“To our knowledge, this is the first report of an iatrogenic CSF leak after a nasal swab for COVID-19,” reads the case study published Thursday in the journal JAMA Otolaryngology – Head & Neck Surgery.
The chilling situation began when the anonymous 40-something patient received a mandatory COVID-19 test prior to an elective hernia operation. The test was administered using a nasal swab, a screening method recommended by the US Centers for Disease Control and Prevention (CDC).
Shortly thereafter, he began experiencing a headache, stiff neck, photosensitivity, vomiting, and a “metallic taste” in his mouth.
Realizing something was wrong, he presented to the hospital, where CT scans revealed a 1.8-centimeter bag of CSF protruding into the sinus cavity between a crack in the bone. Known as an encephalocele, the condition was the result of the bones in his skull not closing completely, leaving a crack where CSF and brain tissue can collect in a sac-like formation, according to Children’s Wisconsin Health System. .
Doctors speculate that the nasal swab ruptured the bag, causing the cerebrospinal fluid that protects the brain to leak out, CTV News reported. In turn, the patient had experienced a change in brain balance called spontaneous intracranial hypotension. The patient also had high pressure in the brain due to the cerebrospinal fluid sac.
An accidental lumbar puncture can seem like gross negligence. However, analysis of a 2017 CT scan revealed that the woman’s encephalocele was misidentified as nasal inflammation.
Armed with this knowledge, the doctors were able to fill the problematic gap in the bone using a soft tissue skin graft.
However, the patient’s case highlights the “need to adequately train clinicians and even the general public” on swab detection, according to the report, as governments around the world implement automatic swabbing and DIY to help protect healthcare workers from contracting the coronavirus.
In order to avoid another inadvertent brain drain, the study proposed alternative screening procedures for patients suffering from sinus problems or skull-related ailments.
