Diagnostic dilemma: A woman heard a "pop" during the Pilates class. Her spine had created a leak.

The patient: A 42-year-old woman in the United Kingdom

The symptoms: During a reformer pilates class – a kind of Pilates that incorporates machines with springs, lending resistance – the patient felt a “pop” in the left side of her neck. About an hour later she developed a headache. The pain decreased somewhat when she lay down. But the headache deteriorated in the next few days and disrupted their daily activities.

What happens next: The woman visited her family doctor, who suspected that the patient had injured one of her Trapezoidal muscleswho move the head, neck and upper back. The doctor prescribed opioid -based pain relievers and muscle relaxants, but these did not make any relief. Also physiotherapy sessions with neck manipulation. After four weeks of constant and intensive pain, the woman looked for further treatment in a hospital.

The diagnosis: When doctors carry A Computer tomography (CT) Scan From the head of the woman they found old blood clots on both sides of her brain, which were between the surface of the brain and the outermost layer of tissue, which is known as Dura Mater. This indicated that there was a trauma that affects the Dura Mater.

The doctors followed the CT scan with an MRI of the patient's spine. The MRI unveiled pools of cerebrospinal fluid (CSF), the clear liquid that typically surrounds it Brain and spinal cord; The CSF was probably held from a tear in the Dura Mater, which appeared during the Pilates class of the woman.

Leckage and accumulation of CSF can cause headaches that worsen when the person's attitude is upright, the hospital doctors wrote In a reportAnd added that this case “increases the possibility that Pilates is a risk factor for the development of a spontaneous CSF leak”.

The treatment: The MRI had not unveiled the location of a dural tear, so the doctors decided to treat the woman with bed rest and caffeinated drinks instead of an operation. Caffeine is suspected Increase the production of CSF and help with the promotion of blood flow in the brain and reduce Headache Severe in some cases.

The patient's headache decreased considerably and it was released two weeks after her recording. During a follow-up visit a month later, the neuroimaging of the skull seemed to be normal. Your headache had disappeared and no further treatment was required. ((In most casesSmaller dural tears alone heal completely.)

What makes the case unique: Spine -csf -lecks are typically caused by injuries to the head or spine, but they can also result from spine surgery or invasive interventions such as a spine or an epidural. These leaks can be difficult to diagnoseHow their symptoms can resemble those of those of AllergiesMigraines or sinus infections. It is therefore not known how often spontaneous CSF leaks can occur.

Other known triggers of CSF leaks are the growth of bone spores along the spine or the connective tissue disorders that weaken the tissue layers around the brain.

“In the literature of” Pilates reformers “cash registers that were associated with a spontaneous CSF clever”, the doctors did not write a documentation in their case report. “According to our knowledge, this is the first case.” Therefore, such an injury would be seen as a very, very rare result of Pilates.

This article only serves for informative purposes and should not offer medical or fitness advice.

Diagnostic dilemma: A woman heard a “pop” during the Pilates class. Her spine had created a leak.

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