What is a CSF leak?
A CSF leak is a leak of the fluid that surrounds the brain and spinal cord, called the cerebrospinal fluid and caused by a hole or tear through the skull bone.
What causes a CSF leak?
A CSF leak can be caused by any tear or hole in the membrane that surrounds the brain and spinal cord. These can allow the cerebrospinal fluid to leak. Specifically, a tear or hole in the membrane can be caused by any of the following:
- Certain head, brain, or spinal surgeries
- Head injuries
- Tube placement for epidural anesthesia or pain medications
- Spinal tap
Sometimes, a particular cause for a CSF leak cannot be found, and the CSF leak is spontaneous. In other circumstances, if the CSF leak keeps coming back, hydrocephalus may be the underlying cause of the leak and should be treated.
What are the symptoms of a CSF leak?
A CSF leak causes pressure to drop around the brain and spinal cord. This decline in pressure can cause the following symptoms:
- A headache that is worse when sitting and improves when lying down
- Light sensitivity
- Neck stiffness
In rarer cases, a CSF leak can cause drainage of cerebrospinal fluid from the ear or from the nose.
How is a CSF leak diagnosed?
A CSF leak can be diagnosed after a physical examination and detailed patient and family history. To confirm a diagnosis, the following tests may be done:
- CT scan of the head with contrast dye
- CT myelogram of the spine
- MRI of the head or spine
- Radioisotope test of the CSF to track the leakage
What are the available treatments for CSF leaks?
Depending on the specific cause of the leak, symptoms of a CSF leak can improve on their own after a few days following complete bed rest for this time. In addition, drinking more fluids, especially drinks with caffeine, can help slow or stop the leak and help with headache pain. Over-the-counter pain relievers can also help treat a headache, but if this headache lasts longer than a week, a blood patch procedure should be done to block the hole that is leaking the cerebrospinal fluid.
Any signs of an infection, such as fever, chills, change in mental state, should be immediately treated with antibiotics.