Cerebrospinal Fluid Leaks

What are Cerebrospinal Fluid Leaks (Spinal Fluid Leaks)?

At the Yale Sinus and Allergy Program, we are specialists in treating cerebrospinal fluid leaks and the symptoms associated with them. 

Cerebrospinal fluid is a clear, colorless fluid that surrounds the spinal cord and brain. When this fluid leaks from the brain or spinal cord, it is called a cerebrospinal fluid leak, or CSF leak. When the fluid leaks, the pressure around the brain and spinal cord drops.

Symptoms of Cerebrospinal Fluid Leaks

If you have a cerebrospinal fluid leak, the clear fluid may drain from your nose or ear(s). The most common symptom is a headache that improves when you lie down and worsens when you sit up. The headache may be accompanied by nausea, light sensitivity, and a stiff neck. 

Please use this information as a guideline, as not all possible symptoms are addressed. Having these symptoms does not mean that you have a cerebrospinal fluid leak. However, if you think that you do, you should contact your doctor right away.

Causes of Cerebrospinal Fluid Leaks

Cerebrospinal fluid can leak if there is a tear or hole in the membrane (thin tissue) that surrounds the brain and spinal cord. 

The most common reasons for the membrane to tear include: 
  • Certain head, brain, or spinal surgeries
  • Head injury
  • Placement of tubes for epidural anesthesia 
  • Spinal tap 

Sometimes, the reason for a cerebrospinal fluid leak is not known.


Risk Factors of Cerebrospinal Fluid Leaks

A risk factor is anything that increases the likelihood of developing a condition. However, having a risk factor does not mean that you will develop the condition. 

The most common risk factors for a cerebrospinal fluid leak include:
  • Head trauma
  • Certain brain or spine surgeries
  • Obesity
  • Skull base tumors
  • Congenital or developmental defects
  • Some spinal procedures

Treatment for Cerebrospinal Fluid Leaks

In most cases, the cerebrospinal fluid leak will heal on its own; bed rest for a few days is the most common recommendation, as well as pain relievers to treat associated headaches. The greatest concern of a CSF leak is developing meningitis, which is a life-threatening bacterial infection, so antibiotics may be prescribed. 

Pneumocephalus, which is a buildup of air within the cranial cavity, is another life-threatening complication associated with CSF leaks. If the leak does not heal on its own, other treatments may include placing a lumbar drain to assist the tear in self-repair or surgical repair of the tear. Surgical repair may be performed via a minimally invasive, endoscopic approach. The term “endoscopic” refers to the use of small nasal telescopes that allow all of the surgery to be performed through the nostrils, without the need for any incisions on the face. Special instruments are then used to repair the damaged tissue. 

If your cerebrospinal fluid leak needs surgical attention, you can rest assured that our surgeons at the Yale Sinus and Allergy Program are specialists in the most-advanced, minimally invasive techniques. We know surgery can seem intimidating, so we take the time to answer all your questions and concerns. We want you to feel comfortable every step of the way.