Cranial leaks occur in the head, and in some of these cases, CSF can leak from the nose, or from the ear. Spontaneous cerebrospinal fluid leaks are classified into two main types: cranial leaks, and spinal leaks. SCSFLS was first described by German neurologist Georg Schaltenbrand in 1938 and by American neurologist Henry Woltman of the Mayo Clinic in the 1950s. Some people with a sCSF leak have a chronic leak of cerebrospinal fluid despite repeated patching attempts, leading to long-term disability due to pain and being unable to be upright, and surgery is often needed. On average, the condition develops at age 42, and women are twice as likely to be affected. A sCSF leak is uncommon but not rare, affecting at least one in 20,000 people and many more who go undiagnosed every year. The set of symptoms associated with a sCSF leak is referred to as a spontaneous cerebrospinal fluid leak syndrome (SCSFLS). Once identified, the leak can often be repaired by an epidural blood patch, an injection of the patient's own blood at the site of the leak, a fibrin glue injection, or surgery. A CT myelography scan can identify the site of a cerebrospinal fluid leakage.
Other symptoms can include neck pain or stiffness, nausea, vomiting, dizziness, fatigue, and a metallic taste in the mouth.
Ī loss of CSF greater than its rate of production leads to a decreased volume inside the skull known as intracranial hypotension.Īny CSF leak is most often characterized by orthostatic headaches, which worsen when standing, and improve when lying down. Spontaneous CSF leaks are associated with heritable connective tissue disorders including Marfan syndrome and Ehlers–Danlos syndromes. Traumatic causes include a lumbar puncture noted by a post-dural-puncture headache, or a fall or other accident. Ī CSF leak is either caused by trauma including that arising from medical interventions or spontaneously sometimes in those with predisposing conditions (known as a spontaneous cerebrospinal fluid leak or sCSF leak). A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. The spinal meninges of the central nervous system impacted by CSF leakĪ cerebrospinal fluid leak ( CSF leak or CSFL) is a medical condition where the cerebrospinal fluid (CSF) surrounding the brain or spinal cord leaks out of one or more holes or tears in the dura mater. Other clinical symptoms may or may not include unconsciousness, nausea, vomiting, neck pain/stiffness, blurred vision, visual field deficits/diplopia, cough headache, facial pain/numbness, tinnitus, taste alternations, limb paresthesias, transient third cranial nerve palsy, neurocognitive decline such as dementia, behavioral changes, and parkinsonism.Medical condition Cerebrospinal fluid leak
PLPH and CSF leak are usually clinically presented as a gradual or thunderclap headache/migraine in onset, more positional over time, can be intermittent, may not be positional and may get better or worse when lying down, although there may be no headache at all. One major problem with an unhealed dural puncture is that it can leak cerebrospinal fluid (CSF), which is called a CSF leak.Ī CSF leak may cause hypotension of the cerebrospinal fluid and let the brain "sag" which can cause headaches/migraines, dizziness, fatigue and and other problems similar to Postural Orthostatic Tachycardia Syndrome (POTS).Īfter a lumbar puncture, Post-Lumbar Puncture Headache (PLPH) is usually caused by CSF leak.
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