MedlinePlus Medical Encyclopedia: CSF leak

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CSF leak

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Cerebrospinal fluid leak

Alternative names Return to top

Intracranial hypotension

Definition Return to top

CSF leak is an escape of the fluid that surrounds the brain and spinal cord, from the cavities within the brain, or from the central canal in the spinal cord.

Causes, incidence, and risk factors Return to top

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 under the following circumstances:

Spontaneously
After surgery:
- Spinal
- Sinus
- Brain
- Head
After penetrating head trauma.

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

Symptoms Return to top

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

Signs and tests Return to top

Diagnosis is usually based on clinical suspicion following a history of trauma, surgery, or lumbar puncture. An MRI may be done to try to confirm the diagnosis.

Treatment Return to top

Depending on the cause of the leak, many cases resolve spontaneously 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 blood patch procedure may be done to block the hole that may be leaking fluid. In most cases, this resolves the symptoms.

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

Expectations (prognosis) Return to top

Prognosis 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.

Complications Return to top

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.

Calling your health care provider Return to top

Call your health care provider if you have symptoms of a headache which gets worse when you sit up, particularly if you have recently had head injury, surgery, or childbirth involving epidural anesthesia.

Prevention Return to top

Measures such as wearing a helmet when riding a bicycle or motorcycle can help prevent head injuries that can lead to CSF leak.

Update Date: 8/1/2004

Updated by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.

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