Cerebrospinal fluid, or CSF, surrounds the brain and spinal cord, providing protection, buoyancy and hormone transportation. When a tear occurs in the dura mater, a membrane that covers the brain and spinal cord, there is a leak of the cerebrospinal fluid, causing a drop in pressure. This tear to the dura mater may occur because of an injury, such as a head injury, or as a complication of a treatment or diagnostic test, such as a lumbar puncture.
Diagnosis of a cerebrospinal fluid leak includes scans, such as a CT or MRI, hearing testing, and testing of the spinal fluid using a beta-trace protein assay. Another diagnostic tool for a CSF leak is a lumbar puncture. However, Columbia Neurosurgery warned that a lumbar puncture may either worsen the CSF leak or cause a new one.
The physician may use a radioisotope test to track the leak of the cerebrospinal fluid. The Mount Sinai Hospital added that in some cases, surgical exploration is the only option to diagnose the condition.
The treatment of a CSF leak depends on the cause of the leak. For example, MedlinePlus noted that in some cases, the condition goes away without needing intervention. Patients should get plenty of bed rest and drink fluids throughout the day.
Beverages that contain caffeine may help to slow or stop the CSF leak, and may also reduce the pain from headaches, according to MedlinePlus. Patients experiencing headache pain may use pain relievers.
In some cases, patients may require further intervention. If a patient has a headache that lasts longer than one week after a lumbar puncture, she may undergo a procedure called a blood patch. With a blood patch, a blood clot is used to seal the CSF leak, thus reducing the symptoms.
Side effects are possible with a blood patch, including increased CSF pressure. If the blood patch fails, patients may undergo surgical repair, noted Columbia Neurosurgery. In cases of a cerebrospinal fluid leak in which a patient has chills, fever and a change in her mental status, the patient will be treated with antibiotics.
Like the treatment, the prognosis for a cerebrospinal fluid leak depends on its cause. MedlinePlus pointed out that for most patients, the leak heals itself and patients do not experience long-term symptoms.
References
MedlinePlus Medical Encyclopedia. CSF Leak. Web. 27 December 2011
http://www.nlm.nih.gov/medlineplus/ency/article/001068.htm
Columbia Neurosurgery. Cerebrospinal Fluid Leaks. Web. 27 December 2011
http://www.columbianeurosurgery.org/conditions/cerebrospinal-fluid-leaks/
The Mount Sinai Hospital. Cerebrospinal Fluid Leak. Web. 27 December 2011
http://www.mountsinai.org/patient-care/health-library/diseases-and-conditions/cerebrospinal-fluid-leak
Reviewed December 28, 2011
by Michele Blacksberg RN
Edited by Jody Smith