Cerebrospinal fluid (CSF) is a protective fluid that provides a cushion for the spinal cord and the brain. Both have three membranes that wrap around them. From innermost to outermost, they are the pia mater, arachnoid mater, and dura mater. CSF is located in the middle of the arachnoid mater and the pia mater and the pia mater and the brain and spinal cord. The brain also has ventricles that produce CSF.
There are two types of CSF leaks, spinal and cranial (located in the brain). A CSF leak can occur when the dura mater is punctured.
Symptoms of CSF leaks change depending on what type of CSF leak you’re experiencing.
Common symptoms of spinal CSF leaks include:
Common symptoms of cranial CSF leaks include:
If you’re experiencing any of these symptoms, it’s important to see a doctor right away.
Common causes of spinal CSF leaks include:
Common causes of cranial CSF leaks include:
CSF leaks can arise spontaneously or because of seemingly small events, such as stretching, coughing, sneezing, and exercising.
Risk factors for CSF leaks include previous spinal surgeries, Ehlers-Danlos syndrome, Marfan syndrome, malformations at the bottom of the skull or inner ear, tumours near the bottom of the skull, sudden head injury, obesity, sleep apnoea, and a history of brain surgeries.
Your doctor will diagnose a CSF leak with a combination of a comprehensive medical history, your current symptoms, and a series of tests.
For spinal CSF leaks, these tests include:
For cranial CSF leaks, these tests include:
Complications of a CSF leak can include infection of the protective membranes of the brain, or meningitis, and air invading the space between the membranes that protect the brain.
Treatment for CSF leaks can include:
Some CSF leaks resolve on their own, and some may resolve with non-invasive measures like bed rest or elevating the head consistently. You can work with your doctor to come up with a treatment plan that is right for you.