What Is Cerebrospinal Fluid (CSF) Leaks
Cerebrospinal Fluid (CSF) Leaks is a condition that occurs when the CSF leaks through a defect in the dura or the skull and out through the nose or ear. A CSF leak results from a hole or tear in the dura, the outermost layer of the meninges. Causes of the hole or tear can include head injury and brain or sinus surgery. These dura tears can allow CSF to leak into the nose. Nasal CSF leaks can occur spontaneously or as a result of trauma or previous sinonasal surgery. This is a very serious condition, and these tears must be repaired in order to prevent meningitis, an infection of the brain tissues. Consult a doctor for medical advice. Back to the conditions page.
Symptoms
- Change in hearing (muffled, ringing in the ears)
- Nausea
- Neck pain or stiffness
- Pain between the shoulder blades
- Phonophobia (sensitivity to sound)
- Photophobia (sensitivity to light)
- Positional headaches, which feel worse when sitting upright and better when lying down
- Sense of imbalance
- Vomiting
Cranial CSF leaks, the most common indicators are:
- Change in hearing or ringing in the ears
- Cutaneous sinus tract drainage (CSF leaks into the sinus tract, which then creates a pathway to drain through the skin)
- Drainage from the ear (otorrhea)
- Drainage from the nose (rhinorrhea)
- Loss of sense of smell (anosmia)
- Salty or metallic taste in the mouth
- Sense of drainage down back of throat
Treatment
- CSF leaks from the ear typically require open surgery
- Epidural blood patch or epidural patching with fibrin glue
- If an epidural blood patch does not work, other surgical repairs may be necessary
- If high-pressure hydrocephalus is causing the CSF leak, the condition may reoccur until shunts are used to help drain the excess fluid
- Leaks into the sinuses can usually be repaired through minimally invasive, endoscopic procedures
- Nasal endoscopy
- Patients with symptoms of the condition should still visit their physician due to the increased risk of meningitis that is associated with cranial CSF leaks
- The treatment of CSF leaks depends on the location of the leak.
- While many CSF leaks heal on their own and require only a period of bed rest
