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Cerebrospinal Fluid Leak

Medically reviewed by Last updated on Oct 31, 2022.

What is a cerebrospinal fluid leak?

A cerebrospinal fluid (CSF) leak happens when there is a tear in the membrane (dura) that contains the fluid. CSF surrounds and cushions your brain and spinal cord.

What puts me at risk for a CSF leak?

  • Conditions that increase the pressure in your skull such as hydrocephalus
  • Sinus and nasal surgeries
  • Closed head injury or skull fracture
  • Tumor at the base of your skull
  • Procedures such as a lumbar puncture

What are the symptoms of a CSF leak?

  • A headache that gets better when you lie down
  • Nausea and vomiting
  • Neck pain and dizziness
  • Changes in your vision, hearing, and balance
  • Sweet or salty taste in your mouth
  • Tingling, burning, or prickling feeling in your arms and fingers

How is a CSF leak diagnosed?

  • Nasal drainage may be tested for the protein found in CSF.
  • A CT scan, or CAT scan, may show the location of your leak. You may be given a contrast liquid before the scan. Tell your provider if you have ever had an allergic reaction to contrast liquid.
  • An MRI may also show the location of your leak. You may be given contrast liquid to help the pictures show up better. Tell your provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell a provider if you have any metal in or on your body.

How is a CSF leak treated?

Treatment will depend on the location and size of your leak.

  • Conservative treatment may be done to decrease pressure and allow the leak to heal on its own. You will need to stay in bed with your head raised and avoid activities that cause pressure. These activities include coughing, vomiting, blowing your nose, and straining to have a bowel movement. Your provider may give you medicines to stop any coughing and vomiting. He or she may also give you medicines to keep your bowel movements soft.
  • A lumbar drain may be done by placing a catheter into your lower back. The catheter will be attached to a drainage collector to drain your CSF. This lowers the pressure, which helps the leak close. CSF diversion is sometimes used with other treatments.
  • A blood patch may be done to close your CSF leak. Your provider will inject a sample of your own blood near the leak. The blood will clot, which may help to close your leak.
  • Surgery is done if none of the other treatments stop your CSF leak.

How do I care for myself while I have a CSF leak?

In order to decrease pressure and allow your CSF leak to heal on its own, you will need to do the following:

  • Stay in bed with your head raised on pillows.
  • Do not blow your nose.
  • Avoid coughing.
  • Avoid vomiting.
  • Avoid straining when you have a bowel movement.

When should I seek immediate care or call 911?

  • Your headaches become worse.
  • You have a fever.
  • You become confused.
  • You have a seizure.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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