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I Have Been Having Symptoms For Approximately 10 Years That

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Posted on Mon, 16 Mar 2020
Twitter Mon, 16 Mar 2020 Answered on
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Question : I have been having symptoms for approximately 10 years that have effected my daily life: a constant headache, extreme fatigue, "brain fog" in general but especially the hour or two after waking up, an inability to concentrate, neck stiffness (with four episodes of acute torticollis), a metallic taste in my mouth that never goes away, increased hoarseness of my voice, a constant high-pitched ringing in my right ear, and a clear fluid leaking intermittently from my right ear.







I saw my family doctor initially for the fluid leaking from my ear and I was told that I had no sign of ear infection but that there was dried, crystallized fluid in my middle ear behind the ear drum. My family doctor said it was most likely "swimmer's ear" and prescribed an ear drop. The fluid leakage never stopped and over the years has become more and more frequent to the point that it's now fairly constant - though there are times when the fluid leakage increases.







Last year, I saw an ENT for the fluid leakage and was told everything looked fine - that the most likely cause of my symptoms is a CSF leak but it can't be possible in my situation because my ear drum is intact so no fluid could leak out. An MRI was done on 10/02/2019 to rule out retrocochlear lesions. No lesions on my MRI, but there was an incidental finding of a 19.2mm cyst in the right lateral atrium of the choroid plexus.







I saw a neurosurgeon who said he is (and I am quoting him) "not concerned with the mass found on the MRI" and that his main concern is that I have all the signs of a CSF leak. So he sent me back to the ENT who ordered the MRI - who, again, swore it can't be a CSF leak.







I sought a second opinion from another neurosurgeon who - also - suspected a CSF leak but said that my MRI did not show any overt leaks and he sent me to another ENT. This second ENT parroted the same thing as the first: I don't know what's wrong but it can't be a CSF leak because your ear drum is intact. Neither this second neurosurgeon or ENT even looked at the scans of the 19.2mm cyst found during the scan.







Over the past 7 or 8 months, a lot of my symptoms have gotten worse. My husband has witnessed the fluid leaking from my ear, even though when I am in a doctor's office no one can see it. It takes me almost two hours to fully wake up from sleep. I never know when I have to use the bathroom because I no longer have a gradual awareness of needing to urinate - it happens all of a sudden and there have been a few times where I almost didn't make it. I struggle a couple of times a day to find a word or name that I know I should know, and I frequently drop things for no reason.







I KNOW something is wrong, but no one will take me seriously. I need help.

The disc I have of my MRI from 10/02/2019 has 12 different series of cuts. I have taken screenshots of the best still in each series, along with the final report.
I hope this is the information you were requesting.
doctor
Answered by Dr. Dr. Erion Spaho (13 hours later)
Brief Answer:
A CT cisternogram is necessary.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query, I saw the MRI report and images that you updated too.

The cyst seems to be a benign one, and I agree with the opinion of the Neurosurgeon that is not the cyst responsible for your symptoms because of the location ( it doesn't affect the cerebrospinal fluid circulation).

I think that you should get evaluated further for the suspected cerebrospinal fluid leak.

This leakage may justify your symptoms due to decreased intracranial pressure.

For this purpose is necessary for a coronal CT cisternogram to be performed.

Discuss with your Doctor for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4494 Questions

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I Have Been Having Symptoms For Approximately 10 Years That

Brief Answer: A CT cisternogram is necessary. Detailed Answer: Hello and welcome to "Ask a Doctor " service. I have read your query, I saw the MRI report and images that you updated too. The cyst seems to be a benign one, and I agree with the opinion of the Neurosurgeon that is not the cyst responsible for your symptoms because of the location ( it doesn't affect the cerebrospinal fluid circulation). I think that you should get evaluated further for the suspected cerebrospinal fluid leak. This leakage may justify your symptoms due to decreased intracranial pressure. For this purpose is necessary for a coronal CT cisternogram to be performed. Discuss with your Doctor for these issues. Hope you found the answer helpful. Let me know if I can assist you further.