Freak Pilates injury causes brain fluid leak

File photo of a magnetic resonance image (MRI) of the brain. istockphoto

A woman who had persistent headaches found there was a strange culprit for her pain: a Pilates class that caused her brain fluid to leak, according to a new case report.

The brain fluid leak led to a persistent, worsening headache that was only alleviated when the 42-year-old British woman laid down, according to the report that was published in December in the Journal of Medical Case Reports.

Though doctors never identified the exact location of the leak, the patient improved after a few weeks of bed rest and pain relievers. [The 16 Oddest Medical Cases]

Cerebrospinal fluid is a clear liquid that flows between the brain and its outer covering, and between the spinal cord and its outer covering. Both of these structures' outer coverings are called the dura. This fluid cushions the brain and spinal cord and helps clear metabolic waste from the brain. However, sometimes holes can emerge in the dura, said Dr. Amber Luong, an otolaryngologist at the University of Texas Health Sciences Center in Houston.

"The most common cause [of such leaks is] trauma, like a car accident," Luong told Live Science. Often, cerebrospinal fluid leaks out of a person's nose because there is a crack in the base of the skull and a tear in the dura lining the brain.

One telltale sign of a cerebrospinal leak is that there is clear, metallic-tasting fluid coming out of just one nostril, Luong said. (The woman in this case did not experience this symptom because her tear was around the spinal cord, not the brain.)

Tumors and botched sinus surgeries can also cause cerebrospinal fluid leaks. Spontaneous leaks with no obvious cause can be due to increased pressure inside the skull, which can erode the bone over time, Luong said.

Spontaneous leaks due to high pressure in the skull are more common in women and people who are overweight. It's also more common in older people, "because it takes some time for that pressure to ultimately erode the bone," she said.

Popping sound

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Freak Pilates injury causes brain fluid leak