The most common symptom of a spinal CSF leak is a headache, while a cranial CSF leak causes symptoms such as clear fluid leaking from the nose or ear. Some CSF leaks may heal with conservative treatments such as bed rest. Many CSF leaks need a blood patch to cover the hole or surgery to repair the leak.
Any tear or hole in the membrane that surrounds the brain and spinal cord (dura) can allow the fluid that surrounds those organs to leak. When it leaks out, the pressure around the brain and spinal cord drops. Causes of leakage through the dura include: Certain head, brain, or spinal surgeries.
The CSF leak is repaired using your own tissue from the nose or with a biomaterial graft. Length of stay in the hospital depends on the size of the leak — most patients are in the hospital for a few days after surgery. Some patients may require a lumbar drain that is removed before going home.
How common is a CSF leak? Spontaneous CSF leaks (ones that are not triggered by a medical procedure such as a lumbar puncture, or by a serious injury such as a gunshot wound) occur in at least five in 100,000 people per year, making them fairly rare.
The classic symptom is a headache that becomes severe when the patient is upright and quickly disappears when the patient is lying flat. So, the headaches are typically absent first thing in the morning, and start or worsen shortly after getting out of bed.
There are currently no home kits or over the counter testing methods for patients to obtain. If you are concerned about a CSF leak, you should contact your primary physician immediately and see a specialist.
The most common symptom of a spinal CSF leak is headache. These headaches usually: Cause pain in the back of the head. Improve when lying down.
Patients may have a CSF leak for years or decades before it is diagnosed. “It is often mysterious where the leak is and what is causing it,” said Ian Carroll, MD, at the 10th Annual Winter Conference of the Headache Cooperative of the Pacific.
A runny nose will usually clear up with the assistance of cold and allergy medications. But when it comes to a CSF leak, it isn't just any runny nose, Dr. Patel said. "Usually with a CSF leak, the dripping is only on one side of the nose—and it drips constantly, like a faucet," Dr.
Untreated CSF leaks can lead to life-threatening meningitis, brain infections, or stroke.
The classic presentation of CSF leaks is the expression of clear, watery drainage from the nose. This occurs usually on one side; however if fluid drains into the back of the throat there may be a salty taste. Drainage also tends to increase when bending over or straining.
Hydrocephalus is a condition of the brain where there is a pressure-induced deterioration of brain functions. It does not go away on its own and needs special treatment.
Normal CSF is a clear, colorless fluid that contains small quantities of glucose (a sugar) and protein. CSF surrounds the outside of the brain and spinal cord and also fills the ventricles (spaces) of the brain and the central canal of the spinal cord.
Hydrocephalus is a build-up of fluid in the brain. The excess fluid puts pressure on the brain, which can damage it. If left untreated, hydrocephalus can be fatal.
Hydrocephalus that develops in children or adults (acquired hydrocephalus) can cause headaches. The headache may be worse when you wake up in the morning. This is because the fluid in your brain does not drain as well while you're lying down and may have built up overnight.
Magnetic resonance imaging (MRI) accurately detects CSF leaks and associated complications such as the encephaloceles and meningoceles.
Any CSF leak is most often characterized by orthostatic headaches, which worsen when standing, and improve when lying down. Other symptoms can include neck pain or stiffness, nausea, vomiting, dizziness, fatigue, and a metallic taste in the mouth.
POTS, orthostatic hypotension, cervicogenic headache, vestibular migraine, and prior Chiari decompression surgery are all causes of orthostatic headache that may mimic spinal CSF leak and must be distinguished for patients to receive appropriately directed therapy.
CSF Leaks and Skull Base Defects
If a CSF leak is suspected, you should see a physician as soon as possible. If symptoms of meningitis (high fever, light sensitivity, neck stiffness) are suspected, you should go to the emergency room.
Myelography. This test is considered the gold standard for diagnosing and locating CSF leaks. It uses digital subtraction fluoroscopy, a CT or MRI scan, and a contrast dye to locate CSF leaks. It provides the most precise location of a CSF leak and helps to determine the most appropriate treatment plan.
Unlike mucus, which is thick and sticky, CSF is clear and watery.
Although head pain is the most common symptom, not every person with spinal CSF leak will experience it. And in fact there are a number of non-headache signs and symptoms.
Hydrocephalus, also called water in the brain, is a condition where there is an abnormal build up of CSF (cerebrospinal fluid) in the cavities (ventricles) of the brain. The build-up is often caused by an obstruction that prevents proper fluid drainage.
Most of posttraumatic CSF leakage resolves within six months after trauma.
Sleep with your head slightly elevated for 7 days. Stay in a bed or chair with your head up during the day for 7 days.