There are a variety of causes of cerebrospinal fluid (CSF) leakage. They include injury to the head or spine, spinal tap and surgery. In some cases, cerebrospinal fluid leakage can be a spontaneous occurrence for which there might be no known cause. In other cases, spontaneous cerebrospinal fluid leakage can happen as a result of intracranial pressure, or a protrusion of the skull bones due to developmental defects. Most of the time, there are not really any ways to prevent cerebrospinal fluid leakage, with the exception of wearing a helmet to protect the head from suffering trauma.
Cerebrospinal fluid itself is fluid surrounding the brain and spinal cord that serves to cushion the brain. A fluid leak causes brain and spinal cord pressure to drop, in addition to giving a person headaches and increasing the chances of infection. Though cerebrospinal fluid leakage usually goes away on its own, in some cases, it can become a serious medical condition since an infection can lead to meningitis, which is a life-threatening situation.
The main symptom of cerebrospinal fluid leakage is a headache that feels worse when sitting or standing up, but gets better when lying down. Nausea, sensitivity to light and a stiff neck are some signs associated with this headache. Additional symptoms are fluid leaks from the ear, nose and surgical wounds, although this leakage is rare. Symptoms of an infection include chills and fever. If these symptoms follow a spinal tap or surgery, the patient should seek immediate medical attention.
Medical history and a variety of tests can help a doctor diagnose cerebrospinal fluid leakage. The doctor will note if the patient has recently suffered head or spinal cord trauma, had brain, head or spinal cord surgery, or recently underwent a spinal tap procedure. Tests that can help in diagnosis and location of the leak include a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan and a radioisotope test.
Cerebrospinal fluid leakage treatment depends on the cause and severity of the condition. Usually, the leak will heal itself from anywhere between a few days to six months. The doctor will typically recommend the patient rest and relieve the headaches with pain medication. In some cases, the doctor will need to block the leak with an epidural blood patch in which a blood clot seals the hole. A serious case of cerebrospinal fluid leakage will require surgery, such as an endoscopic endonasal approach (EEA), to repair the problem.