A WOMAN who was suffering from a constant headache was shocked to discover it was because her brain fluid was leaking following a Pilates class.

The 42-year-old woman went to A&E at King's College Hospital, London, after being unable to cope with the pain for four weeks.

She told doctors it started when she felt her neck "pop" during a Pilates reformer class – which involves exercising on a machine using straps and ropes.

Within an hour she developed a headache, which only improved if she lay down, according to her 2014 case published in the Journal of Medical Case Reports.

It started to get progressively worse over the next few days so she went to see her GP who said it was a neck muscle injury and given painkillers as well as a muscle relaxant.

She also had physiotherapy sessions, which included intensive neck manipulation, but the headache continued so she took herself to hospital.

Doctors writing in the case report, said: "The severity of the headache had a profound impact on her ability to perform her activities of daily living."

Baffled

They were initially stumped as her pulse and blood pressure were normal and there were no signs of meningitis.

But when they carried out a CT scan they found blood was pooling in two spots outside her brain, while an MRI scan showed pockets of cerebrospinal fluid (CSF) – the protective fluid that is found around the brain and spine – was leaking.

Medics said the woman had a tear in the lining of her spinal cord around her neck, but they couldn't pinpoint exactly where.

They said that this type of leak causes low brain fluid, which can lead to headaches either when sitting or standing.

The woman's condition improved with bed rest and she was discharged from hospital after two weeks.

After a month, a brain scan revealed her head was back to normal and she reported that her her headache had disappeared.

Writing in the case report, the doctors said: "Our patient responded well to the conservative management with a significant improvement in her headaches."

They also noted that Pilates could be a risk factor for the development of a spontaneous leak of cerebrospinal fluid.

However, they pointed out that this is the first recorded case of this happening.

The team said: "The underlying cause of spontaneous CSF leaks remains unknown but there is an association with connective tissue disorders.

"Up to 20 per cent of patients have subtle sketetal abnormalities such as those seen in Marfan syndrome with no other stigmata of the disease.

"In our patient, there was no evidence of a connective tissue disease and we feel that a trivial traumatic event during her Pilates class resulted in the development of a dural tear.

"There has been no previous documentation in the literature of ‘Pilates reformer’ classes being associated with a spontaneous spinal CSF leak and, to our knowledge, this is the first case."

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