Cerebrospinal fluid leak

Cerebrospinal fluid (CSF) leak is an abnormal communication of the fluid surrounding the brain and spinal cord with the exterior, or any place other than the brain and spinal cord.

Symptoms may include nasal dripping (rhinorrhea), otic dripping (otorrhea), meningitis, headaches.

These leaks are present due to traumatic events, following surgery, congenital anomalies, among others.

The diagnosis is based on clinical findings and medical history. In most instances diagnostic imaging is performed trying to identify the leak site.

Treatment depends on the cause, the size of the defect and the amount of discharge. In some occasions only bed rest and medications may be used, in others lumbar drain may be needed.

In other cases, due to the origin of the leak, cranial surgery may be performed, either endoscopic endonasal or through cranial surgery. In these cases the use of grafts is indicated, usually muscle grafts improving CSF closure.