Cerebral Spinal Fluid Leaks

Cerebrospinal fluid (CSF) surrounds the brain and spine, and is encased in a membrane known as the dura. Sometimes, a CSF leak develops from a defect in the dura, allowing fluid to leak from the nose or ear. CSF leaks can be caused by head injuries, various surgeries, or spontaneously from high pressure inside the skull.

Symptoms of Cerebrospinal Fluid Leaks

Symptoms of a CSF leak include a watery, clear discharge from the nose or ear, and a headache that is more painful when standing upright than when lying down. If accompanied by nausea, photosensitivity and a stiff neck, an infection may be present. If a CSF leak is not repaired, serious and potentially fatal complications, including meningitis or swelling of the brain, may arise.

Diagnosis of Cerebrospinal Fluid Leaks

Diagnosis is usually based on the patient's history of injury combined with a focused physical examination. Necessary workup may include testing of fluid samples, as well as various types of imaging, to include CT and MRI.

Treatment of Cerebrospinal Fluid Leaks

Some CSF leaks may resolve spontaneously. For CSF leaks that do not heal on their own, surgery is used to repair the problem area. To repair a CSF leak in the sinuses, transnasal, endoscopic surgery is usually performed. The patient's tissue is used to create a plug that stops the leakage. To repair a CSF leak from the ear, bone removal (craniotomy) may be necessary, providing access to the area of concern. The procedure may require the help of a neurosurgeon, and both physicians work together to repair the defect.

Cerebral Spinal Fluid Leaks