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Alternative Names Return to topIntracranial hypotension
Definition Return to top
A CSF leak is an escape of the fluid that surrounds the brain and spinal cord.
Causes Return to top
The dura is the membrane that surrounds the brain and spinal cord and contains the cerebrospinal fluid (CSF). CSF can leak from any hole or tear in the dura.
Causes of a tear in the dura include:
Sometimes there is no cause.
Symptoms Return to top
Symptoms may include:
Exams and Tests Return to top
Diagnosis is usually based on your history of injury, surgery, or lumbar puncture.
Tests may include:
Treatment Return to top
Depending on the cause of the leak, many cases go away on their own after a few days. Complete bed rest for several days is usually recommended.
Headache may be treated with pain relievers and fluids. If the headache lasts longer than a week after a lumbar puncture, a procedure may be done to block the hole that may be leaking fluid. This is called a blood patch, because a blood clot can be used to clog the leak. In most cases, this makes symptoms go away. Rarely, surgery is needed to repair a tear in the dura and stop the headache.
If symptoms of infection occur (fever, chills, change in mental status), antibiotic therapy is needed.
Outlook (Prognosis) Return to top
The outlook is usually good depending on the cause. Most cases heal by themselves with no lasting symptoms.
Possible Complications Return to top
Complications may occur if the cause is surgery or trauma. Infections can cause serious complications, such as swelling of the brain.
When to Contact a Medical Professional Return to top
Call your health care provider if:
Prevention Return to top
Measures such as wearing a helmet when riding a bicycle or motorcycle can help prevent head injuries that can lead to CSF leak.
References Return to topHeegaard WG, Biros MH. Head. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006:chap 38. Update Date: 9/22/2008 Updated by: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.