A cerebrospinal fluid (CSF) leak is a medical condition categorized by a tear or opening in the membranes that surround the brain or spinal cord, which allows the clear fluid that surrounds these body parts to escape. Leaks can develop for a number of different reasons, some of which are harder to diagnose than others, but once you understand where the leak is and what caused it, treatment is usually very successful. Below, we take a closer look at the causes, symptoms and treatment options for cerebrospinal fluid leaks.
Causes and Symptoms
Cerebrospinal fluid leaks can develop for reasons unknown, or there can be a direct cause. Some diagnosable causes of CSF leaks include head or spine trauma, complications following a surgery in the area, failure to clot after a lumbar puncture procedure or the development of a tumor. Patients with hydrocephalus, a condition that causes abnormal overproduction of cerebrospinal fluid, are also at an elevated risk for developing a leak.
Symptoms of a CSF leak include:
- Headaches
- Headaches that worsen when sitting up
- Nausea
- Vomiting
- Neck stiffness
- Difficulty hearing
- Balance issues
- Sensitivity to light or sound
- Shoulder pain
As you can see, these symptoms aren’t all that unique, so it’s not always easy to detect if you’re dealing with a CSF leak without a comprehensive diagnosis.
Diagnosis and Treatment
Diagnosing a CSF leak will begin with a physical examine and a conversation about your symptoms and medical history. Your provider will also talk about what causes symptoms to increase or decrease. If a CSF leak is suspected, imaging testing will be ordered in order to find the precise location of the leak. This can be achieved with a CT scan, an MRI, or lesser known tests like myelography or a cisternogram.
Once the location and the underlying cause of the leak has been deduced, a treatment plan can begin to form. The good news is that many leaks heal on their own with bed rest and time, as this allows the body to naturally close off the hole. For leaks that don’t respond to rest, a more hands-on approach may be necessary. This can usually be achieved with an epidural blood patch. This involves injecting the patient’s own blood into the area, which will then clot and seal the leak.
If that also fails, or if you have an underlying condition like hydrocephalus, the insertion of shunts or other hardware may be necessary to close off the leak. Overall, cerebrospinal fluid leaks have great healing rates with conservative care techniques, while cranial leaks also have good healing rates, but may require more hands-on intervention.
If you believe you’re dealing with a CSF leak, or you are dealing with another spinal or brain issue, reach out to Dr. Chang’s office today.