🧠 Cerebrospinal Fluid (CSF) Leak
A cerebrospinal fluid leak occurs when the fluid surrounding the brain and spinal cord escapes through a tear or hole in the dura mater (the protective membrane).
🧬 Causes:
- Head trauma or injury
- Surgical procedures involving the brain or spine
- Spontaneous leaks due to weakness in the dura (sometimes linked to high pressure in the brain)
- Tumors or infections eroding the dura
🩺 Symptoms:
- Clear, watery drainage from the nose or ear (often worsens when leaning forward)
- Headache, often worse when sitting or standing (low-pressure headache)
- Neck stiffness
- Nausea or vomiting
- Sensitivity to light or sound
- Possible signs of meningitis (fever, neck pain) if infection occurs
🔍 Diagnosis:
- Physical exam and symptom history
- Testing the nasal or ear fluid for beta-2 transferrin (a protein unique to CSF)
- Imaging (CT scan, MRI, or CT cisternography) to locate the leak
💊 Treatment:
- Bed rest and head elevation to allow healing
- Avoiding activities that increase pressure (straining, heavy lifting)
- Fluids and caffeine to help reduce symptoms
- If persistent, lumbar drain placement to divert fluid and reduce pressure
- Surgical repair to close the leak if conservative measures fail
⚠️ Complications:
- Meningitis (infection of the brain lining)
- Persistent headaches and neurological symptoms
- Recurrence of the leak