{"id":52619,"date":"2025-04-25T22:03:33","date_gmt":"2025-04-26T02:03:33","guid":{"rendered":"https:\/\/www.hancockhealth.org\/mayo-health-library\/csf-leak-cerebrospinal-fluid-leak\/"},"modified":"2026-02-04T12:06:48","modified_gmt":"2026-02-04T17:06:48","slug":"csf-leak-cerebrospinal-fluid-leak","status":"publish","type":"mayo","link":"https:\/\/www.hancockhealth.org\/zh\/mayo-health-library\/csf-leak-cerebrospinal-fluid-leak\/","title":{"rendered":"CSF leak (Cerebrospinal fluid leak)"},"content":{"rendered":"<div class=\"container mx-auto   wordpress-block wordpress- core-\">\n<p>Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are three layers that surround the spinal cord and brain. When there is a hole or tear in the outermost layer, a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak occurs. The hole or tear in this outer layer, called the dura mater, allows some of the fluid to escape.<\/p>\n<p>There are two distinct types of <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks: spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks and cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks. Each type has different symptoms, causes and treatments.<\/p>\n<p>A spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak occurs anywhere in the spinal column. The most common symptom of a spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak is a headache.<\/p>\n<p>A cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear.<\/p>\n<p>\u4e00\u4e9b <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may heal with bed rest and other conservative treatment. Many <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks need a patch to cover the hole or surgery to repair the leak.<\/p>\n<p>Symptoms vary between spinal and cranial <abbr title=\"cerebrospinal fluid \">CSF<\/abbr> leaks.<\/p>\n<h3>Spinal CSF leaks<\/h3>\n<p>The most common symptom of a spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak is a headache. These headaches usually:<\/p>\n<ul>\n<li>Cause pain in the back of the head.<\/li>\n<li>Improve when lying down.<\/li>\n<li>Worsen when standing up.<\/li>\n<li>May start or worsen when coughing or straining.<\/li>\n<li>Rarely, start suddenly. When this happens, it is called a &#8220;thunderclap&#8221; headache.<\/li>\n<\/ul>\n<p>Other symptoms of spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may include:<\/p>\n<ul>\n<li>Neck or shoulder pain.<\/li>\n<li>Ringing in the ears.<\/li>\n<li>Changes in hearing.<\/li>\n<li>Dizziness.<\/li>\n<li>Nausea or vomiting.<\/li>\n<li>Changes in vision.<\/li>\n<li>Changes in behavior or ability to think clearly.<\/li>\n<\/ul>\n<h3>Cranial CSF leaks<\/h3>\n<p>Cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak symptoms may include:<\/p>\n<ul>\n<li>Clear, watery drainage from one side of the nose or ear.<\/li>\n<li>Hearing loss.<\/li>\n<li>A metallic taste in the mouth.<\/li>\n<li>Meningitis.<\/li>\n<\/ul>\n<p>Spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may be caused by:<\/p>\n<ul>\n<li>A spinal tap, also called a lumbar puncture.<\/li>\n<li>An epidural in the spine for pain relief, such as during labor and delivery.<\/li>\n<li>An injury to the head or spine.<\/li>\n<li>Bone spurs along the spine.<\/li>\n<li>Irregularities of the dura mater around the nerve roots in the spine.<\/li>\n<li>Irregular connections between dura mater and veins. These are referred to as <abbr title=\"cerebrospinal fluid\">CSF<\/abbr>-venous fistulas.<\/li>\n<li>Prior surgery on the spine.<\/li>\n<\/ul>\n<p>Cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may be caused by:<\/p>\n<ul>\n<li>A head injury.<\/li>\n<li>Sinus surgery.<\/li>\n<li>Increased pressure in the brain.<\/li>\n<li>Malformations of the inner ear.<\/li>\n<\/ul>\n<p>Sometimes <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks develop after very minor events:<\/p>\n<ul>\n<li>Sneezing.<\/li>\n<li>Coughing.<\/li>\n<li>Straining to have a bowel movement.<\/li>\n<li>Lifting heavy objects.<\/li>\n<li>Falling.<\/li>\n<li>\u4f38\u5c55\u904b\u52d5\u3002<\/li>\n<li>\u935b\u7149\u3002<\/li>\n<\/ul>\n<p>When there is no surgery or procedure prior to the start of a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak, it is called a spontaneous <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak.<\/p>\n<p>Risk factors for spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks include:<\/p>\n<ul>\n<li>Having a previous surgery or procedure on or around the spine.<\/li>\n<li>Connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome, which often also cause joint hypermobility and dislocations.<\/li>\n<\/ul>\n<p>Risk factors for cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks include:<\/p>\n<ul>\n<li>Having a previous surgery on or around the skull.<\/li>\n<li>Obesity.<\/li>\n<li>Obstructive sleep apnea.<\/li>\n<li>Head trauma.<\/li>\n<li>Tumor at the skull base.<\/li>\n<li>Irregularities of the skull base or inner ear.<\/li>\n<\/ul>\n<p>If a cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain. Untreated spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may lead to subdural hematomas, or bleeding on the surface of the brain.<\/p>\n<h3>Spinal CSF leak<\/h3>\n<p>Your healthcare professional will likely start by asking about your medical history and conducting a physical exam.<\/p>\n<p>Tests to diagnose a spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak may include:<\/p>\n<ul>\n<li><strong>Magnetic resonance imaging (MRI) with gadolinium.<\/strong> \u4e00\u500b <abbr title=\"magnetic resonance imaging\">\u6838\u78c1\u5171\u632f\u6210\u50cf<\/abbr> scan uses a magnetic field and radio waves to produce detailed images of the brain, spinal cord and other areas of the body. Using <abbr title=\"magnetic resonance imaging\">\u6838\u78c1\u5171\u632f\u6210\u50cf<\/abbr> with gadolinium makes it easier to see any changes in the spine that result from a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak. Gadolinium is a substance called a contrast agent that highlights tissues in the body.<\/li>\n<li><strong>Radioisotope cisternography.<\/strong> This test involves measuring the <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> pressure and then injecting a chemical into the space surrounding the spinal cord. Then, several images of the area are taken over a 24-hour period. These images watch for changes in the flow of <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> that may indicate a leak.<\/li>\n<li><strong>Myelography.<\/strong> This imaging test uses a contrast dye and X-rays or computed tomography (CT) to take detailed pictures of the spine. It can find the exact location of a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak and helps to determine the most appropriate treatment plan.<\/li>\n<li><strong>Spinal tap.<\/strong> This test also is called lumbar puncture. It involves placing a needle in the spinal column to measure the pressure of <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> inside the spinal column. It is usually performed as part of another test for <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak. For example, a spinal tap is required at the start of myelography or cisternography.<\/li>\n<\/ul>\n<h3>Cranial CSF leak<\/h3>\n<p>Your healthcare professional will likely start with your medical history and a physical exam. The physical exam includes close evaluation of your nose and ears. You may be asked to lean forward to check for any nasal discharge, which may be collected and sent to a lab for testing.<\/p>\n<p>Tests to diagnose a cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak may include:<\/p>\n<ul>\n<li><strong><abbr title=\"Magnetic resonance imaging\">\u6838\u78c1\u5171\u632f\u6210\u50cf<\/abbr> with gadolinium.<\/strong> \u4e00\u500b <abbr title=\"magnetic resonance imaging\">\u6838\u78c1\u5171\u632f\u6210\u50cf<\/abbr> scan may be used to help detect a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak inside the brain. Using it with gadolinium, a contrast agent, helps to highlight irregularities in the brain and locate the source of a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak.<\/li>\n<li><strong>Tympanometry. <\/strong>This test uses a handheld device called a tympanometer. The probe on the tympanometer is inserted into the ear to measure middle ear function and check for fluid. Clear fluid coming out of the ear is a symptom of a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak.<\/li>\n<li><strong><abbr title=\"Computerized tomography\">CT<\/abbr> cisternography.<\/strong> This test is considered the gold standard for diagnosing and locating cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks. It uses a <abbr title=\"computerized tomography\">CT<\/abbr> scan and a contrast dye to locate <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks anywhere in the skull base. This test can show exactly where a <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak is, and help to determine the most appropriate treatment plan. High-resolution <abbr title=\"computerized tomography\">CT<\/abbr> provides images in even greater detail and also may be used.<\/li>\n<\/ul>\n<p>\u4e00\u4e9b <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks improve with bed rest alone, but most need treatment.<\/p>\n<p>Treatments for spinal <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks may include:<\/p>\n<ul>\n<li><strong>Epidural blood patch.<\/strong> This treatment involves taking a sample of your own blood, then injecting it into the spinal canal. The blood cells form a clot, which can create a patch to cover the area where the <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> is leaking.<\/li>\n<li><strong>Fibrin sealant.<\/strong> Fibrin sealant is special glue made from substances in human plasma that help with blood clotting. Used alone or mixed with your blood, it is injected into the spinal canal to cover the hole and stop the <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak. <\/li>\n<li><strong>Surgery.<\/strong> \u4e00\u4e9b <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks need surgery. Surgery is performed if the other treatment options don&#8217;t work and the precise site of the leak is known. There are several types of surgical treatments that repair <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks. Surgery may involve repairing the <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leak with stitches or grafts made from patches of muscle or fat.<\/li>\n<li><strong>Trans-venous embolization.<\/strong> This minimally invasive procedure is used only for <abbr title=\"cerebrospinal fluid\">CSF<\/abbr>-venous fistulas. <abbr title=\"Cerebrospinal fluid\">CSF<\/abbr>-venous fistulas are irregular connections that occur in the spine and allow <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> fluid to leak into the blood vessels. Trans-venous embolization stops the leak by gluing shut the fistula from inside the affected vein.<\/li>\n<\/ul>\n<p>Some cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks, such as those caused by trauma, may improve with conservative measures such as:<\/p>\n<ul>\n<li>Bed rest.<\/li>\n<li>Elevating the head of the bed.<\/li>\n<li>Taking stool softeners to prevent straining.<\/li>\n<\/ul>\n<p>Other cranial <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks require surgical repair.<\/p>\n<p>After discussing your symptoms with your healthcare professional, you might receive a referral to see a doctor trained in brain and spine conditions for further evaluation. Doctors with this training include neurologists, neurosurgeons and ENTs.<\/p>\n<p>Here&#8217;s some information to help you get ready for your appointment.<\/p>\n<h3>What you can do<\/h3>\n<p>Make a list of:<\/p>\n<ul>\n<li><strong>Your symptoms,<\/strong> including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began.<\/li>\n<li><strong>Key personal information,<\/strong> including major stresses or recent life changes.<\/li>\n<li><strong>All medicines, vitamins or other supplements<\/strong> you take, including doses.<\/li>\n<li><strong>Questions to ask<\/strong> your healthcare team.<\/li>\n<\/ul>\n<p>Bring with you to the appointment recent test results and scans of your brain and spine. Take a family member or friend along, if possible, to help you remember the information you receive.<\/p>\n<p>For <abbr title=\"cerebrospinal fluid\">CSF<\/abbr> leaks, questions to ask your healthcare provider include:<\/p>\n<ul>\n<li>What is likely causing my symptoms or condition?<\/li>\n<li>What tests do I need?<\/li>\n<li>Is my condition likely temporary or long-lasting?<\/li>\n<li>What is the best course of action?<\/li>\n<li>Would losing weight help my condition?<\/li>\n<li>I have these other health conditions. How can I best manage them together?<\/li>\n<li>Are there restrictions I need to follow?<\/li>\n<li>Should I see a specialist?<\/li>\n<li>Are there brochures or other printed material that I can have? What websites do you recommend?<\/li>\n<\/ul>\n<p>Don&#8217;t hesitate to ask other questions.<\/p>\n<h3>What to expect from your doctor<\/h3>\n<p>Your healthcare professional is likely to ask you questions, including:<\/p>\n<ul>\n<li>Have your symptoms been continuous or do they come and go?<\/li>\n<li>How severe are your symptoms?<\/li>\n<li>What, if anything, seems to improve your symptoms?<\/li>\n<li>What, if anything, seems to worsen your symptoms?<\/li>\n<\/ul>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Cerebrospinal fluid leaks may start in the brain or spine, causing headaches, dizziness and other symptoms.<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","tags":[1686,1685,1682],"class_list":["post-52619","mayo","type-mayo","status-publish","hentry","tag-anatomical-structure","tag-condition","tag-person-group-concept","content_type-diseases-conditions"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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