Cerebrospinal Fluid Leak
A cerebrospinal fluid (CSF) leak is an escape of the colorless fluid that surrounds the brain and spinal cord. Cerebrospinal fluid is continuously produced in cavities in the brain called ventricles and absorbed into the bloodstream. It cushions the brain, acting as a shock absorber, and serves as a vehicle for delivering nutrients to and removing waste from the brain.
A CSF leak can cause the pressure within the skull to drop to an abnormally low level, a condition called intracranial hypotension. The loss of CSF volume causes the normally buoyant brain to sag within the skull, resulting in headaches and other neurological symptoms.
How common is a cerebrospinal fluid leak?
CSF leaks are rare. They occur at a rate of approximately five cases for every 100,000 people, though this number is thought to be an underestimate.
Who gets cerebrospinal fluid leaks?
Anyone can have a cerebrospinal fluid leak, and sometimes no cause can be found. With that being said, they are more common in certain groups of people, including:
- People between the ages of 30 and 40 years
- People with connective tissue disorders like Ehlers-Danlos and Marfan syndromes
Possible causes of a CSF leak include:
- Certain head or spine surgeries
- Head or back injury
- Placement of tubes for epidural anesthesia or pain medications
- Lumbar puncture (spinal tap)
How is a cerebrospinal fluid leak diagnosed?
Your doctor may use the following to diagnose a cerebrospinal fluid leak:
- Lumbar puncture
- Magnetic resonance imaging (MRI)
Symptoms of a cerebrospinal fluid leak include:
- Positional headache, which worsens when you sit up and improves when you lie down
- Light sensitivity
- Neck stiffness
- Hearing changes
Contact a medical professional if you are experiencing symptoms.
Depending on the cause of the leak, symptoms may resolve on their own. Your doctor may recommend bed rest, drinking more fluids, increasing your caffeine intake, and taking pain relievers.
If your symptoms do not improve with conservative treatments, your doctor may suggest an epidural blood patch. This procedure involves injecting your own blood into the area around the spinal cord to seal off the leak. Surgery may be needed to repair the leak in some instances.
Information and Resources About Cerebrospinal Fluid Leak
- Date of last review: May 1, 2018
- Author: Kerry Knievel, DO