Clinical Specialties

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Clinical Specialties
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Cerebrospinal fluid (CSF) Leaks

DEFINITION

A cerebrospinal fluid leak is the clear drainage that comes when the natural sac that surrounds the brain has a tear. Normally, the brain floats in a small amount of fluid in the skull, called the cerebrospinal fluid or CSF. This CSF is held in place by a sac called the meninges. In adults, cerebrospinal fluid leaks may occur as a result of trauma, obesity, high intracranial pressure or causes. Patient's typically experience clear drainage from one nostril which is worsened with bending, exercise and straining. Cerebrospinal fluid leaks may cause serious complications such as meningitis (inflammation of the brain membranes) or pneumocephalus (air in the brain).

SYMPTOMS
Clear drainage from the nose, headache

DIAGNOSIS
Diagnosis of cerebrospinal fluid leak is made after a physical exam and history taken by your doctor. Your doctor will likely want to take some pictures of the head including an X-ray of the skull, a CT scan or MRI scan which can show if there are breaks in the bones and possible leaks, though the leaks themselves are generally too small to be seen. Depending on the location, your doctor will either have you see an Ear, Nose and Throat (ENT) Doctor or a Neurosurgeon.

TREATMENT
Traditionally, these leaks were repaired using large skull incisions, making bone flaps, retracting the brain, finding the leak and repairing it. Newer, minimally invasive endoscopic techniques allow the surgeon's to find and repair these leaks through the patient's nose, and natural opening, thus avoiding skull incisions. Patient's typically experience fewer complications, decreased pain, and leave the hospital quicker with the use of these techniques.

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