Cerebrospinal Fluid Leak

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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What is a cerebrospinal fluid (CSF) leak?

A 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 increases my risk for a CSF leak?

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

What are the symptoms of a CSF leak?

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

How is a CSF leak diagnosed?

Your healthcare provider will examine you and ask about your symptoms. Tell your provider about any recent injury or surgery you have had. You may need any of the following:

• A drainage sample from your nose or ears may be tested for the protein found in CSF.
• CT or MRI pictures may show the location of your leak. You may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid. The MRI machine uses a powerful magnet. Do not enter the MRI room with anything metal. Metal can cause serious injury from the magnet. Tell a healthcare 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 helps decrease pressure and allows 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. Your provider may also give you medicines to keep your bowel movements soft.
• A lumbar drain is a catheter placed into your lower back. The catheter will be attached to a drainage collector to drain your CSF. This lowers the pressure and helps the leak close.
• 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 and seal the leak.
• Surgery may be needed if no other treatments stop your CSF leak.

Call your local emergency number (911 in the US), or have someone call if:

• You have a seizure.

When should I seek immediate care?

• Your headaches become worse.
• You become confused.
• You have increased neck pain or stiffness.
• You have a fever.

When should I call my doctor?

• You have questions or concerns about your condition or care.

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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