Engineer finds relief for headaches caused by CSF leak

Professionally, Jack Stockbridge, of Waterford, boasts an impressive work history. A career engineer, he has contributed to factory construction, computer and engine development, and the creation of a noise containment approach for Michigan’s rifle ranges. His pioneering work earned him 24 patents and multiple awards. Yet, despite his problem-solving expertise, he faced a challenge he never expected: mysterious, debilitating headaches that defied explanation.

A subtle sign of trouble

Years before his diagnosis, Jack experienced subtle symptoms. “It all started with a ghost image in one eye, a very mild second image above a point of light,” he recalls. Multiple optometrists examined him, but none found cause for concern.

A headache unlike any other

One morning in 2018, Jack woke up with a crushing headache that worsened when he was upright but eased when he lay down. “It would gradually go away when I laid down and would slowly return over a couple of hours when I was up,” he remembers. The pain, sharp and persistent at the back of his head, led him on a search for answers.

His Henry Ford primary care physician, Christina Blake, DO, ordered preliminary tests and referred him to specialists. Over time, doctors ruled out meningitis, brain tumors, infections, cancer, head trauma and blood disorders. Despite the thorough evaluations, the headaches persisted.

A breakthrough diagnosis: Cerebrospinal Fluid (CSF) leak

Determined to find the root cause, Jack was referred to Dace Zvirbulis, MD, neurologist and headache specialist at the Henry Ford Headache and Facial Pain Center. After a meticulous review of his symptoms and exam, Dr. Zvirbulis delivered the long-awaited diagnosis: a major cerebrospinal fluid (CSF) leak caused by spontaneous intracranial hypotension (SIH), a rare neurological disorder. The leak causes a drop in CSF volume, which can lead to brain sagging and headaches.

Dr. Zvirbulis explains SIH can take months to years to diagnose due to various symptoms that can mimic other headache disorders and medical conditions. If untreated, this condition can lead to chronic debilitating symptoms, like severe headache, vision changes, even life-threatening complications such as subdural hematoma, bleeding on top of the brain and blood clot formation in the veins around the brain, she explains. “On some occasions, the condition can even lead to diminished consciousness, including coma and death.”

Despite the serious diagnosis, Jack was relieved to have an answer at last. “I am from Northwest England, an area that is a hot spot for CSF leaks. After hearing the diagnosis, my first thought was, ‘That makes sense.’ It was a strong feeling of relief.”

Genetic testing revealed that Jack carried a genetic predisposition linked to CSF leaks, kidney issues, and spontaneous lung collapses, conditions that had also affected his family members.

A long road to recovery

Jack’s case was considered extreme. His initial treatment took him to California, where specialists performed spinal surgery to seal three leaks using surgical clips and a fiber-reinforced glue. The headaches disappeared immediately, but recovery from the surgery took months. Doctors warned that, due to the genetic nature of his condition, new leaks could develop over time.

CSF leaks return, but new hope arises with a leading-edge solution at Henry Ford

As predicted, new leaks returned six years after his initial treatment. Jack returned to Dr. Zvirbulis, along with Horia Marin, MD, a specialist in cerebrovascular disease and interventional neuroradiology, and Ali Arafat, MD, a diagnostic radiologist. The Henry Ford team worked together to locate and repair two leaks.

This time, a minimally invasive treatment called Cerebrospinal Fluid (CSF) Venous Fistula Embolization was used to treat the CSF leak. Dr. Zvirbulis says the procedure aims to block or close the abnormal connections between the CSF spaces and the venous system, known as fistulas, which cause the CSF to leak. During the procedure the physician inserts a thin, flexible tube called a catheter into a large blood vessel. Using real-time X-ray guidance (fluoroscopy), the physician guides the catheter through the blood vessels to the site of the fistula. Once the catheter is in place, the physician injects a special glue-like substance through the catheter to block the fistula and fix the CSF leak.

“It is very important to have a multidisciplinary team with experience in treating CSF leak,” notes Dr. Zvirbulis. In Jack’s case, that meant a headache neurologist, neuroradiologist, interventional neuroradiologist and neurosurgeon, due to the complexity of the treatment required.

Jack was very pleased with the results. “The two-hour procedure left only a small mark on my leg, and I couldn’t be happier with the outcome.”

A new lease on life

Thanks to his specialized care team and innovative surgery at Henry Ford, Jack now enjoys an improved quality of life with his wife of 53 years and their two children. He has returned to his favorite activities, including kayaking, snowmobiling, woodworking, fishing and cooking. To help manage his condition, he also drinks caffeinated beverages, which can promote CSF production and constrict blood vessels.

“The team at Henry Ford -- from Dr. Blake, who guided me through the process, to Dr. Zvirbulis, Dr. Marin, and Dr. Arafat -- has been phenomenal,” Jack says. “They personally followed up, ensured my condition was resolved, and answered all my questions.”

For further information visit the Headache and Facial Pain Center at Henry Ford.