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CSF - Brain Fluid Leaks

Definition

CSF leak is an escape of the fluid that surrounds the brain and spinal cord.

Causes

The dura is the membrane that surrounds the brain and spinal cord and contains the cerebrospinal fluid (CSF). A tear in the dura may occur without cause, after certain head, brain, or spinal surgeries, or after a head injury.


CSF leak can also be caused by a lumbar puncture (spinal tap) or by placement of tubes used for epidural anesthesia or pain medications.

Symptoms

Symptoms usually include a headache that is worse with sitting up and improves when you lay down. Leakage of CSF from a tear of the dura in the head can also cause a runny nose.

Exams and Tests

Diagnosis is usually based on the person's history of injury, surgery, or lumbar puncture. An MRI may be done to try to confirm the diagnosis.

Treatment

Definition

Depending on the cause of the leak, many cases go away on their own after a few days. Complete bed rest for several days is usually recommended.


Headache may be treated with pain relievers and fluids. If the headache persists longer than a week after a lumbar puncture, a procedure may be done to block the hole that may be leaking fluid. In most cases, this makes symptoms go away.

If symptoms of infection occur (fever, chills, change in mental status), antibiotic therapy is required.

Outlook (Prognosis)

diagnosis is usually good depending on the cause. Most cases heal spontaneously with no lasting symptoms. If the leak is due to head trauma or surgery, complications may be caused by underlying conditions. Careful attention should be paid to the possibility of infection, which can also cause serious complications.

Possible Complications

Complications may occur if the underlying cause is surgery or trauma. Infections can cause serious complications such as swelling of the brain. CSF leak due to a lumbar puncture usually resolves satisfactorily.


Content courtesy of AAO American Academy of Otolaryngology

Associated Treatments
Imaged Guided Surgical Navigation  

Associated Technologies
Image Guided Surgical Navigation  

Associated Physicians
Karen J. Fong, M.D. Winston C. Vaughan, M.D.

NOTE: This information is not intended to substitute for a consultation with your physician. It is offered to educate the patient and his or her family on the basis of otolaryngology conditions in order to get the most out of their office visits and consultations. Please see our disclaimer for additional information.