White House press secretary James Brady may undergo more major surgery as early as next week to close an abnormal passageway through which spinal fluid is draining from the area around his healing brain injuries.
Small amounts of the clear, watery fluid leaked from his nose both Monday and yesterday, George Washington University doctors reported. If there is persistent leakage, it will "increase the likelihood" of surgery sometime in the next several weeks, they said.
The operation, if it takes place, would be the fourth since Brady was shot in the head March 30 in the assassination attempt on President Reagan.
The danger is not loss of the fluid that bathes the brain. The amount leaking away is measured only in drops, and the body continually manufactures a fresh supply. But infection could reach the brain via the same abnormal route, Dr. Dennis O'Leary, G.W. medical spokesman, explained.
"This isn't seen as a high or imminent risk, so his doctors want to be sure he is in the best possible shape," O'Leary added.
In California, where the president is vacationing, deputy press secretary Larry Speakes called the surgery "fairly likely." O'Leary said "the decision really hinges" on whether there is continuing evidence of a worrisome leakage -- and a possible pathway for potentially serious infection.
Brady had a major epilepsy-like seizure only nine days ago, and his doctors are still adjusting the dosage of two anti-seizure drugs to get the right amount in the blood to prevent more seizures.
Meanwhile, the doctors said, Brady is alert, in good spirits and in good condition.