Can maxillary fracture cause csf leak?

I would like to know if an injury caused by brutal force continuously applied for several minutes that caused a crack from the gum line up into the area behind the left nostril would be sufficient to cause a csf leak? A dental student was doing impressions and became irritated with a number of things about my procedure, including my first set of impressions not coming out correctly. He proceeded to wedge both of his hands inside my mouth and forcibly lock my head between his abdomen and his hands while applying so much pressure that my maxilla cracked. I was left with black and purple gums, the roof of my mouth was bruised all the way back and I could not eat anything for over a week and could not eat solids for over a month. This is not a legal matter, the time has already passed on that. This is a matter of my health and well being.

I have a majority of the symptoms of a csf leak. In fact I learned of csf leaks because I was dx with basilar migraines and advised to "look them up on the internet". In the information it says "if you have these symptoms along with clear fluid coming from nose, ears or eyes see also; csf leak. I've had 3 MRI's the first to rule out Chiari Malformation, as my neuro was certain that I had this due to my symptoms. If requested I can put the entire report, but most everything they listed said "normal" next to it . The things that concern me are, the first MRI (w/o contrast) came back with findings that included "Visualized paranasal sinuses show mild mucosal thickening of maxillary sinuses and ethmoid air cells." Impression: Normal MRI brain and no Chiari Malformation  My Cine MRI CSF flow study (w/o contrast) says the images are suboptimal and the impression: No significant abnormality. My latest MRI, skull base with intravenous contrast, I've not seen the report but the doctor sent me an email response: "As for the MRI, there was mild arthritis, but not enough to cause any blockage and the base of the skull-meninges looked fine. It makes me wonder about your sinuses anyway. Did you have sinus surgery?"

I have shared the above information about the maxillary fracture though the only xrays I have are the little dental type that are taken of the teeth, but the fracture can be seen. I am trying to get a copy of those.

I have intermittent leaking of fluid (looks like water, tastes salty) that ranges from a few uniform drops here and there to streaming non-stop at times, depending on the pressure build up in my head. I have debilitating headaches (especially after exerting myself, ie: cleaning house) that can only be relieved (not stopped, but made more bearable) by laying completely flat on my back with my neck propped on a rolled towel or pillow so that my head tilts back. I've been to the ER a number of times for these HA, they used to give me toradol shots but they haven't been working, the last time they gave me dilaudid. My vision has gotten progressively worse. Vision was perfect prior to injury and onset of symptoms, then I started having stars and floaters a year ago. The floaters used to be almost transparent and could only be seen at times. Now they are gray and are constantly in my field of vision, also I was told recently that I now need bifocals. I have also been diagnosed with Sicca syndrome due to my constant extreme dryness in all of my mucous membranes (neg SS-A and SS-B) Prior to learning about CSF I used to say it was like all of the fluid in my body comes out of my nose. I wake up every day feeling as if my brain is dehydrated...I know that is probably a weird description, but that is what it feels like.

I would also like to know for a B2Tr test is it only worth while to collect when the fluid is pure water? Typically I get a few drops at a time when I'm doing something that requires tilting my head down. When it starts streaming out (due to pressure build up) it aggravates my sinuses or something and a massive amount of crystal clear thin mucous starts pouring out with it. (ie: I was sitting on the couch watching a movie, propped my head up on my hand and the liquid started, before I could make it to the bathroom to grab a tissue I had to put my hand out in front of me to catch the copious stream of clear fluid) The mucous is never sticky. It is almost like a slightly thicker version of water. I soaked through one of the thick 4x4 gauze pads from the ER and when it dried it was as if it had never even been used.  I have the test tubes to collect in but I don't want to risk a false negative by sending any that have mucous. Can the mucous interfere with proper testing? I am really suffering, I have an HMO that I'm locked into until Nov. and feel as if nobody is taking this very seriously because the MRI findings are "normal". I've not had any MRIs or CTs that include a tracing agent being injected into the CSF. I would like to know, based on the information given here would this be a reasonable test for me to have done? (I worry because I know that it can potentially open you up to more leaks)

I thank you in advance for any help you can provide.

[girlygirl333]

I should also mention that while the leaking from my nose is intermittent their is almost always leaking into my throat. It is salty with a tinge of bitterness, tastes kind of like the flavor of baking soda mixed in water.

[selmaS]

HI...may I ask u how u feel in general?..With a CSF leak u would most deff be in the dark, lying down and not able to do much. I had one and believe me...u would know if u had one.

U can get a CSF leak from dental work and even surgery on ur sinues....and there are articles on spontanious CSF leaks....

Have u been to an ENT dr?....this may be a place to start since u have the drainage in ur nose and throat area.Maybe it is post nasal drip?

Keep us posted
"selma"

[girlygirl333]

Thank you for your reply *smile* When I have symptom flare-ups, guaranteed onset with any strenuous activity, I have a very stiff neck, debilitating HA and head pressure that require me to be in a dark room, no noise, no light, laying flat with neck propped up on a bolster, head tilted back and icepacks all around my head/neck. Often times vomiting. I do understand your experience with a csf leak and this is very similar to what my first neuro told me. However I have since talked to a number of people that have ongoing small, slow and/or intermittent leaks (sometimes for a decade or more before they are properly diagnosed/treated) that have experiences similar to, if not exactly like mine.
I did see an ENT and he said "I do sinus surgery and from what I can see you don't need sinus surgery". He referred me back to neuro.