A CSF leak occurs when a tear or hole in the membranes surrounding your brain and spinal cord allows cerebrospinal fluid to escape. This can cause a variety of symptoms, including headaches and nausea and vomiting.
CSF leaks are common and most often occur when there has been a head injury. Blunt force injuries such as a car accident or whiplash can cause a tear in the dura mater, the tissue that lines the inside of your skull.
These injuries can also cause a CSF leak in your ears, nose and sinuses. Symptoms include a runny nose, which can lead to clear fluid draining from your mouth and nose (cSF rhinorrhea).
Another sign that you might have a CSF leak is if you notice a watery discharge from one side of your nose or ear when you tilt your head forward. This may smell salty or metallic and is often worse when you get up after lying down.
If your doctor suspects you have a CSF leak, they’ll do tests to determine the location of the leak and how large it is. These tests can include a CSF discharge test, which uses filter paper to separate the fluid from blood and mucus. The doctor then looks for a “double ring” sign that appears when the fluid is separated from the other materials.
They might also test your blood to see if there’s a protein called beta transferrin that normally only exists in the CSF. This test can tell the doctor whether a tear or hole in the dura is causing the leak.
Once they know the location of the leak, a doctor can treat it with surgery, an injection of your own blood to close the holes, or a procedure called a blood patch. These treatments can help prevent future CSF leaks and can reduce the pressure inside your head.
The symptoms of a CSF leak can be very serious, and should not be ignored. They can cause serious infections, such as meningitis, that need to be treated quickly.
Symptoms usually improve with time, but they can last months or years. Your doctor will likely suggest you rest and avoid activities that cause bending or stretching your neck.
In some cases, a CSF leak will heal by itself. But if it does not, treatment can be necessary to relieve pain, nausea and vomiting.
Your doctor might also suggest you get a CT myelography scan to see where the leak is located. The scan can reveal the cause of the leak, and can help doctors determine if it’s caused by a herniated disc or other condition.
A lumbar drain can be done to help ease the pressure in your brain and help alleviate your symptoms. You’ll need to keep your back straight and avoid bending, twisting or lifting things for 4 to 6 weeks after the surgery to prevent further problems.
If you have a CSF leak and it’s getting worse, go to the emergency room immediately. This can help your doctor diagnose and treat it more quickly, and ensure that you’re not at risk for infections or complications from the leak.
