Spinal fluid leak
What is it?
A spinal fluid leak, also known as cerebrospinal fluid (CSF) leak, occurs when the fluid that surrounds and cushions the brain and spinal cord, called cerebrospinal fluid, escapes through a hole or tear in the dura mater, the tough outer membrane of the spinal cord and brain.
Trauma, such as an injury to the spine, can cause a tear in the dura mater. Medical procedures, such as lumbar puncture (spinal tap), epidural injections, or spinal surgery, can sometimes result in a cerebrospinal fluid (CSF) leak. Although less common, spontaneous tears in the dura mater can also occur. Connective tissue disorders, like Ehlers-Danlos syndrome, can also make individuals more prone to dural tears.
Symptoms
A spinal fluid leak can cause a range of symptoms, such as headache, neck stiffness or pain, nausea, vomiting, sensitivity to light and sound, changes in hearing, dizziness, visual changes, fatigue, and changes in the sense of smell and taste. Symptoms can vary in intensity and duration. Seek medical attention if you suspect a spinal fluid leak.
Diagnosis
When trying to diagnose a cerebral fluid leak, a doctor will conduct a physical examination, review the medical history, and order imaging tests such as CT scans or MRI to determine the leak’s location. In some cases, a myelogram test may be used as well.
Treatment
The treatment outcome depends on the leak’s severity and cause. While conservative treatment can resolve many leaks, some may require more invasive interventions. To treat the leak conservatively, bed rest is recommended to reduce symptoms and speed up the healing process. Drinking plenty of water and caffeine can help alleviate headache symptoms. An epidural blood patch may be recommended if the leak is severe. The patient’s blood is injected into the epidural space during this procedure to promote clotting and seal the leak. Surgical repair may be necessary if the leak is not resolved with any of these treatments.