A Mayo Clinic doctor has pioneered a new procedure to treat a medical problem that causes positional headaches, among other symptoms. And he took a “novel” approach to find the solution.
Reporter Jason Howland has the story.
Journalists: Broadcast-quality video (2:15) is in the downloads at the end of this post. Please courtesy: “Mayo Clinic News Network.” Read the script.
Sometimes, extraordinary ideas are inspired by the most ordinary things.
It started with a problem: a cerebrospinal fluid venous fistula, or what is called a CSF venous fistula. It’s an abnormal connection between the fluid that surrounds the spinal cord and a blood vessel that runs along the spine.
“The fluid around the spinal cord is leaking too fast into a little vein causing the patients to lose that fluid and then get symptoms like headaches, brain fog, whooshing in the ears and just general malaise,” says Dr. Brinjikji.
Treatments either had been ineffective or required back surgery and a prolonged recovery time. Dr. Brinjikji knew there had to be a better way. And rather than searching for the answer using the latest in digital technology, he bought a 50-year-old medical textbook.
“It was published in the 1970s, looking at spinal veins. I was paging through the book. I saw that there were these beautiful pictures of the azygos vein and beautiful pictures of other veins draining into it. And I said, ‘Oh, these are the veins that are draining these CSF venous fistulas,'” says Dr. Brinjikji. “So I started thinking, what if we just blocked off the vein that it’s draining into? And we do this for all sorts of other abnormal fistulas.”
Using X-ray guidance, a catheter is navigated up the vein and medical glue is placed on the fistula, essentially plugging the spinal fluid leak. The results of this minimally invasive procedure that Dr. Brinjikji has pioneered have been positive for most of his patients.
“The day after, they feel 100% better, and their headaches have gone away. And they’ve never had a day like this in years,” says Dr. Brinjikji.
After performing this new procedure on more than 50 patients at Mayo, Dr. Brinjikji is confident that this is the future of CSF venous fistula treatment.
“I would say it’s the present. And I think it is the future,” he says.
A future that all started by looking into the past.
“Just finding this old book, you know, and just page through it, and it can just change your life,” says Dr. Brinjikji.
For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.