The pouch got pierced by the swab, and just like piercing a water balloon that’s attached to a faucet, it immediately started leaking clear cerebrospinal fluid. Instead, there was an out-pouching of the brain’s lining, known as an encephalocele, filled with spinal fluid. Radiologic imaging of her brain and sinuses demonstrated a one-inch area where there was no bony roof of her nose. The sack of the encephalocele got nicked by the Covid-19 swab. The combination of these two entities led to a small defect in the bone between the roof of the nose and the brain, and she had developed a pocket of the brain’s lining prolapsing into the nose, known as an encephalocele. As published in the October issue of JAMA Otolaryngology, it turned out that she had had prior nasal polyp surgery two decades ago, as well as a history of disorder called intracranial hypertension, or increased pressure of the fluid surrounding the brain. In addition, the fact that a runny nose is just on one side is often a tip-off of something unusual. That’s what a spinal fluid leak can look like, which is what she had. ![]() ![]() Picture your kitchen sink trickling out water if it’s not fully turned off. This was not the type of drainage one would get from allergies, a cold, or even a sinus infection. Soon after, she developed headache, nausea, vomiting, and clear watery drainage from the side of her nose where the swab had been placed. A 40-year-old woman in Iowa underwent a nasopharyngeal Covid-19 swab test as part of her preoperative clearance for an elective hernia repair.
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