What is CSF leak headache?
Cerebrospinal fluid (CSF) is a watery fluid that circulates through the brain’s ventricles, around the surface of the brain and spinal cord. A CSF leak is a condition that occurs when the CSF leaks through a defect in the dura of the skull or spine. A CSF leak results from a hole or a tear in the dura, the outermost layer of the meninges. Causes of the hole or tear can include injury to the head and brain or sinus-related surgery. CSF leaks may also occur after a lumbar puncture, also called a spinal tap or spinal anesthesia. Spontaneous CSF leaks can also occur with diseases of the spine presenting as neck and back pains. Some CSF leaks cause dementia and parkinsonian symptoms which is reversible with treatment.
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Treatments
Treatment options for a CSF leak depend on its cause and the location of the leak. Some sudden leaks are treated with rest, hydration and caffeine.
Patients with memory problems and parkinsonian symptoms require surgical interventions such as:
Spinal CSF leaks
- An epidural blood patch is the most common treatment for spinal CSF leaks. In this procedure, your blood is injected into the spinal canal.
- Use of grafting materials, such as epidural fibrin glue, or fat or muscle patches, may be tried.
- Other surgical approaches to repair the leak include using stitches or aneurysm clips.
Cranial CSF leaks
- CSF leaks from your nose can usually be repaired using nasal endoscopy
- CSF leaks into your ear will usually need the use of a microscope with a synthetic graft/a piece of your tissue.
- If hydrocephalus is suspected to be the cause of the CSF leak, a lumbar drain may also be placed in the lower back to decrease intracranial pressure.