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Possible blockage or csf leak
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Possible blockage or csf leak

The post on CSF leak has me posting my own questions.  For quite a while I have been experinecing headaches that dont go away.  Plus a contant pressure on the right side of my head where I actaully feel a release of fluid.  I have the fluid draining into both ears which has now caused them to have a ringing sound.  I also feel in the back of my neck a crackle as you do when the ears are full.  I have been to doctor after doctor and taken many tests.  Though I see problems with my test.  I have asked doctors each time what they could be and each doctor gave me a different answer.  I also expereince a problem when my nose runs heavily.  I actually feel the fluid not draining properly.  I finally showed one doctor the spots on my MRI and CT scan of the head,  he said they were artifacts.  He is sending me for a CT cisternogram in the next week I have the appointment.  The spot shows up bright white with contrast.  Does anyone have an idea if this could be my problem or maybe even a blockage?  I really want to get better and doctors are not helping me.  My MRI's even say that I have a low signal in the mastoid air cells.  I asked many doctors if this could all be related and was told no.  How I dont know especially when my ears are feeling like they do.  If someone can tell me what to do or other testing please let me know.  thank you
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Avatar_n_tn
I cannot comment on your imaging findings based on your text, and without seeing the images, therefore I cannot tell you what the white spots are.

A CSF leak develops most of the time in the setting of previous head trauma or basal skull fracture - in this case a chronic fluid leak can develop. I do not know if this is consistent with your case. If there is low pressure in the CSF system causing headaches, this can be evaluted by doign a spinal tap and measuring the CSF pressure.
Other tests such as a cisternogram sa you are doing or a nuclear medicine test can help aid in the diagnosis. Measuring the sodium, and glucose content of the fluid from the ear or nose can help differentiate it from just nasal/serous secretions.

Good luck
14 Comments
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Avatar_n_tn
I saw a new ENT yesterday. He said allot of times allergies will cause fluid in the ears. Something to look into. In my case, I have allready been on Claratin and Flonaze and stuff like that so he thinks it is less likely but I'm trying something else to clear everything out of the sinus region. He said the other possibility is CSF leak. With my history of head trauma and not responding to other meds, he is leaning towards that. He ordered lots of tests.

Maybe try the allergy route while looking into a leak? Can't hurt.
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Avatar_n_tn
been thru all the allergy testing nothing helped. Thats why I know it has to be something else.  thanks...
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Avatar_n_tn
What is csf?My ears have been leaking for many years when i wake up in the morning they are pretty bad!!!I have been pretty sick for six months now!!!With pretty bad bowell problems and when i sleep at night my hands fall asleep at night and i mean every night even when laying on my back and during the day my left shoulder is numb this has been going on for three months the numbness...I have had all kinds of tests done as far as the liver goes i thought is was my liver doing everything but hida scan and liver blood tests and ultrasound and colonscopy comes back normal even blood test for hep a-b-c and hiv are neg and cbc blood work comes back normal i have been fighting with my gi doc and my pcp to get in to see a neur doc and they will not give me the dang referel to see one!!!They say mine is all axiety and i cant beleave that!!I think for a male of 35 that has never done drugs and eats right should fill like this but maby my ears could be doing me problems i have never had them checked out...
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Avatar_n_tn
cerebralspinal fluid. It's the fluid that surrounds the brain and fills the spinal cord. Ear draining can be from outside the ear through the external canal or into the sinus. It's usually an infection, allergies, can be a inner ear problem, or CSF leak. A leak doesn't fit well with numbness in an extremity though. I agree you should see a neurologist. Could be a damaged nerve/s (carpel tunnel), peripheal neuropathy, spinal problem in your neck putting pressure on your spinal cord, or a number of other things. Doesn't sound like anxiaty but that can cause many problems. Switch Docs if your not satisfied.
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Avatar_f_tn
A sipmle test can be performed to see if the fluid draining from your nose / ears is CSF.   I believe that CSF should contain sugar, whereas most other mucousy fluids would not.  

Could this be a very bad case of sinusitis / mastoiditis?
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Avatar_n_tn
i see yeah iam going to get my gi doc to get me in to see a nero doc since my pcp will not!!I have been trying for months to post a ? on here and never can..
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Avatar_n_tn
i had one doctor make me use glucose test strips for about two weeks and test each day.  Each day the glucose strip tested positive for glucose.  In turn I went to a bunch of neuro/ent who told me those tests are completely inaccurate so It is not possible.  What they dont know is how my head feels so I not its possible.  I am hoping one day soon some doctor will listen and more than anythig help.  My mri show masotidiitis which again doctors told me it cant be related. Either its me or the doctors I have been going to excuse me and no offenses taken but they are a bunch of morons.
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Avatar_n_tn
Glucose testing for CSF has fallen out of favor. CSF does contain glucose where the other fluids normally will not and this used to be the identifing factor. However, because glucose is used up very fast, testing required refigeration and quick transportation and testing. False negatives were the norm. Glucose strips can be an 'in house' pre-identifier but will not be considered conclusive by medical professionals. They should be taken seriously though for further evaluation. Beta2 Transferin (spelling) is now the testing method used to detect CSF. If your Docs, are not familuar with this test, they do not have enough information to properly pursue a CSF leak. Get a new Doc.

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Avatar_n_tn
fcar, a while back I did some pushups and felt pressure in the back right of head for 3 months after that. I also heard popping due to that pressure buildup when I slept some nights. I also occasionally heard a squirting sound in the back of my head. Very disturbing.

I'm wondering if you headaches and pressure were caused by exercise or a neck strain at all? Do you also feel more lethargic after you hear these fluids? Recently I've started thinking the majority of my headaches and other symptoms were all due to torn muscles in my neck. At the time, it certainly didn't feel that way.
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Avatar_n_tn
My problems started after a sinus infection.  I had a really bad sinus infection and have never felt better since then.  No sinus medication or antibiotics  works.  I just dont understand how doctors keep missing something.  On two films that I have in the auditory canal there is a white spot that shows up with contrast. One film was a CT scan of the brain taken about 2 months ago.  The MRI was taken beginging of year.  I finally found a doctor that said the spots were artifacts didnt know what they were, so he sent me for another MRI.  This MRI showed nothing.  Which doesnt make sense.  I have two films that show something and this one came up nothing.  I asked the doctor if it was possible that the slices were cut to thick and  missed the area.  Its easy to see when you compare the films that the area they image are different.  I know I have no medical training but if something shows up in two prior exrays it leads me to beleive each place takes didnt slices of the area mabye too thick and it doesnt see the problem.  I know it didnt go away because my head is worse so I am back to square one.  The ironic part is the spot show up on the right side of my head which is where I keep telling doctors I feel the pain and release of fluid coming from.  No one puts anything together.  By the way when I showed the spots to other doctors would you believe these were the responses I got from all different doctors, one said it was thickening of the skull, one said I was wearing an earring (just one), another said I moved my head during filming.  One said it was a major nerve ( I asked if  it was a major nerve why isnt on both sides of the film no anwer) and another said it was a major artery which nerves and arteries are completely different and are on both sides of the head not one.  I certainly cant figure out how  each has a different thought.  Since all the doctors said something different I have to beleive they are all wrong and a bunch of morons.  Sorry no offenses.
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Avatar_f_tn
Oh boy...    Perhaps, going to a large academic center would help.   It may take a while to get in but may be worth it.  Find a large medical school with a big neurology department in it, and find a good and experienced doc there.
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Avatar_n_tn
Hi Fcar,

Just wondering where exactly you hear the fluids? What does it sound like? Does the sound only last a second or do fluids seem to slosh around all the time?

Where is the pressure and how long have you had the problem for?

Do you have any neck issues or feel vertigo at all? Are you lethargic, can you hear your pulse in your head? Anything like that...

MRI's are frustrating. Doctors depend on them to be the final diagnosis for someone who is either fit and healthy or seriously ill. My MRI came up normal and I suffered 4 months because my neuro diagnosed me with anxiety. My new neuro looked into it more and although he couldn't find anything we tried some medications (Epilim) and I'm feeling so much better.

Epilim is meant to help people with epilepsy but it also assists with muscle problems and blood flow issues in the head (although its not licensed? for that). Maybe you should ask about it... takes about 4 days to kick in. I'm on a very small dosage. one in morning, one at night.

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Avatar_n_tn
I feel the fluid on the right side of my head.  All of a sudden I feel a pressure and than the realease of fluid draining into my ears and neck area. I have constant headaches and pressure even in the ears with ringing.  It can be sporadic the draining, but the headaches is constant.  

Hoping though my test after the holidays shows somehting.

It started a couple years ago after a sinus infection.  (been to doctor after doctor)  Odd though each test I have taken (did mention this I think) each radiologist reports somehting different dont know how when my head doesnt change.  I truly belive I am being missdiagonosed.

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