What Is a Spinal CSF Leak?
Cerebrospinal fluid can leak out from around the spine due to a hole in the dura, the dense tissue that surrounds the brain and spine. The hole can result from:
- A tear caused by a bone spur
- An abnormal connection that forms with a nearby vein
- A traumatic injury
- Placement of an epidural catheter for childbirth or pain management
The tear and resulting leak of cerebrospinal fluid can cause you to lose the protective cushion of fluid around the brain and spinal cord. Low cerebrospinal fluid pressure leads to chronic headaches and other debilitating symptoms including:
- Severe headaches, especially when upright
- New persistent headaches that occur daily, often starting abruptly
- Double or blurry vision
- Ringing in the ears or hearing loss
If You Experience These Symptoms
Because these symptoms may indicate a variety of neurological concerns, CSF leaks are often misdiagnosed. If you are experiencing these symptoms and have not found relief through standard medical treatments, consider evaluation for a spinal CSF leak.
Seek Care from a Neuroradiologist
Duke neuroradiologists specialize in using high-resolution CT, MRI, and fluoroscopic imaging to diagnose and treat CSF leaks and other conditions that affect the brain, spine, head, and neck.
Treatment Options for Spinal CSF Leaks
When conservative treatments such as bed rest and hydration don’t relieve symptoms, a procedure is often required to repair a CSF leak. Depending on the cause of the leak, one of these customized treatments may be recommended. Recovery can take several weeks. After your procedure, our team will contact you often to monitor your progress.
Your own blood or, in some cases, a type of surgical glue is used to create a patch that seals the leak. With CT fluoroscopic guidance, the blood and/or glue is injected adjacent to the tear or potential site of the leak. If the precise location isn’t known, one or more patches may be placed. This procedure is performed after you are given medication to help you relax and to reduce pain.
If the leak is caused by the sharp edge of a bone spur rubbing against the dura, a spine surgeon can repair the leak and remove the spur causing the problem.
Venous Fistula Surgery and Embolization
Sometimes a loss of cerebrospinal fluid occurs due to CSF draining too quickly into the venous system through an abnormal blood vessel connection called a fistula. A neurosurgeon can treat the leak by disconnecting the abnormal vein.
Another option is embolization of the fistula. For this procedure, an interventional radiologist uses an imaging-guided, minimally invasive technique to navigate a small catheter to the fistula and seal it off using medical glue.