CSF leak or just PCS?
 

Hi,

Question:

Is a metallic taste in the mouth necessarily a CSF leak or is it just associated with common head trauma and concussion and post concussion syndrome.


Background:

About 7-8 weeks ago I received a head injury in the side of a head (I walked into a corner of a rectangular solid pole at full speed whilst looking sideways). Its been a struggle since but I am regaining strength and coming back into myself. I also got a good dose of whiplash around the C1/C2 and C1/skull. I noticed shortly after the accident that there was a strong taste of blood in my mouth, a metallic taste. When I presented to ER I told the doctor about the metallic taste and he looked at me as if he had no clue. I also said I can feel draining in my sinuses, which have since resolved. My neurological test were fine and he did not refer me to a CT. I did have a CT about 1 week later that showed nothing. Apart from the pain at the site of impact, headaches, fatigue and the whiplash, I have been suffering a mix of vertigo conditions (cervical and BPPV), the vertigo, fatigue and headaches are getting less intense but still there and usually comes on in the afternoon with a metallic taste in my mouth. Now to me this is ticking the boxes of a CSF leak although no-one I have seen has mentioned it yet and I am a little worried. I do think my doctor is very competent but I recall he too was perplexed at the metallic taste in my mouth. After reading this forum I made the decision to not go back to work until I was ready, the risk is just too great. The rest seems to be working (well as much rest as you can get with a 9 month old kid), but sort of at crossroads and wondering about the CSF leak as I have recently been swimming in public pools.

Many thanks in advance for comments.

le-accidental,

Welcome to NeuroTalk.

I experience the metallic taste just about any time I jostle my head. One ER doc understood it as a symptom of a concussion like event. From what I've read, CSF tastes salty, not metallic.

Thank you for replying Mark. Its hard to define the taste, its a little salty but more metallic and is definitely correlated with a feeling of pain (almost tissue tear feeling) between the base of my skull and C1. It comes on during the second half of the day, but will come on earlier if I do an activity which involves moving my head alot and flexing the skull/C1 section.

Has anyone here had experience with whiplash and a CFS leak?

The CSF leaks that result in a salty taste emanate in the sinuses and drain down into the throat. There is usually a clear fluid draining down the throat.

I can't imagine what a tissue tear feeling would be like. CSF leaks usually are very small tears. They are often plugged with clotted blood.

In my opinion, you are making too much of this issue. Most of us with PCS have a variety of strange symptoms. PCS causes us to tend to get overly focused on a simple sensation that we would have ignored previously. If it is a serious concern, you should be seen by a neurologist or neurosurgeon.

I take your point Mark but usually my intuition is correct with my body. I am a scientist by profession (medical physicist) so I know how it can get with self diagnosing over the internet. Really what I am after here is anyone with whiplash/head trauma that was then diagnosed with a CSF leak and just how were they treated. The one you are describing is a different type of spontaneous leak that is only sometime associated with head trauma. This is an interesting abstract to look at.

Epidural blood patch therapy for chronic whiplash-associated disorder.
**edit**
I am considering trying a short course of oral steroids as a first attempt to get this under control. Getting a contrasted MRI or a CT is fairly risky for your long term health and I will only go down that route if I need to. Hence my question to anyone here, has anyone with a CSF leak been successfully treated with steroids? And of those who had whiplash?

Our CSF Leak forum link , you may find more information there and if it might be related to your injury or not.
http://neurotalk.psychcentral.com/forum78.html

Thanks for the link