Townsville woman’s headaches turned out to be a leaking brain and spine

This retired nurse thought she just had a nasty headache, but in reality, fluid was leaking from her brain and spine. This is what doctors did next.

Rose Kruze recently reunited with the Townsville doctors who helped her reclaim her life after discovering her debilitating headaches were actually caused by a cerebrospinal fluid leak.

North Ward resident Rose Kruze thought she was just dealing with run-of-the-mill headaches after a bad fall last June.

But the pain was actually a symptom of a rare, under-diagnosed condition – a cerebrospinal fluid (CSF) leak.

The retired nurse said two weeks after falling and breaking her arm she began experiencing severe headaches, which she initially blamed on sinus or tension issues.

“I put it down to the trauma of the fall,” she said.

She tried managing the pain with Panadol and rest, but it only got worse. Soon, she struggled to do simple things like watch a play or hold a conversation.

When the pain became unbearable six weeks on, she sought help at the Mater Hospital, where a CT scan revealed a brain bleed.

She was referred to Townsville University Hospital, where doctors discovered she had a CSF leak – a condition where fluid around the brain and spinal cord escapes through a leak or tear.

For four months, Ms Kruze underwent MRIs and procedures as doctors searched for the source of the leak.

Using a dynamic myelogram, her neurosurgeon Dr Ramon Navarro said they were finally able to pinpoint its location in her spine near the TF vertebra.

“(Leaks are) usually very tiny, but give a lot of trouble. That’s why it’s difficult to find … like a needle in a haystack,” he said.

“It’s usually in the spine … and the brain floats on fluid. So, if you take the fluid from below, the brain will sag, leading to severe headaches, usually when you stand up and fogginess.”

After finding the leak, interventional neuroradiologist Dr Muhammad Usman Manzoor performed a transvenous embolisation procedure on her in November, the first of its kind in Queensland for this diagnosis.

Rose Kruze recently reunited with the Townsville doctors who helped her reclaim her life after discovering her debilitating headaches were actually caused by a cerebrospinal fluid leak. She's picture with Dr Usman Manzoor (left) and Dr Ramon Navarro.

Instead of open surgery, the team opted for a less invasive approach which also required a shorter recovery time.

“What we did was we entered through one of the veins of her leg, took our catheters up, navigated into the vein where we knew the fistula or the abnormal connection was,” Dr Manzoor explained.

“Once we were in there, we used special glue to basically plug the fistula, plug the hole between the CSF and the vein.

“It was an instant cure and the next day, when we saw Rose, she was very happy. She did not have any headaches.”

Dr Manzoor noted that CSF leaks are likely under-diagnosed because headaches are such a common complaint.

“Headaches can be due to multiple reasons and one of the rare causes is obviously a CSF leak but people usually exclude that diagnosis but I think if you are careful and if you have experience, you can identify that on the imaging features, and try to find the leak,” he said.

Ms Kruze said she’s grateful to the hospital team for taking her symptoms seriously and not giving up until they found the cause.

Now, four months post-surgery, she’s returned to her active lifestyle of workouts, yoga, and spending time with her grandchildren – all of which were impossible during her ordeal.

She hopes her story will help raise awareness of her rare condition and help others get diagnosed sooner.

Originally published as Townsville woman’s headaches turned out to be a leaking brain and spine