If high-pressure hydrocephalus is causing the CSF leak, the condition may reoccur until shunts are used to help drain the excess fluid. If an epidural blood patch does not work, other surgical repairs may be necessary. The resulting blood clot then "patches" the hole where the leak is occurring. An epidural blood patch involves injecting the patient’s own blood into the spinal canal. The Cedars-Sinai Sinus Center has extensive experience in the use of nasal endoscopy, which is much less invasive than traditional surgical methods.įor spinal CSF leaks that do not respond to bed rest and other conservative treatments, an epidural blood patch or epidural patching with fibrin glue are treatment options. While many CSF leaks heal on their own and require only a period of bed rest, patients with symptoms of the condition should still visit their physician due to the increased risk of meningitis that is associated with cranial CSF leaks.įor cranial cerebrospinal fluid leaks that do not respond to conservative treatments, surgery may be necessary to repair the leak. How is a cerebrospinal fluid leak treated? A CT scan, MRI, myelogram or a cisternogram can assist the physician in determining the location of the leak in either the cranial or spinal area. The pledget test, however, cannot be used to determine the location of the leak. Cisternogram, which can determine if there is abnormal cerebrospinal fluid flow within the brain or spinal canalĪ pledget test may be used to determine if a cranial CSF leak is occurring by placing small cotton pads (pledgets) in the nose.CSF surrounds and cushions your brain and spinal cord. A cerebrospinal fluid leak occurs when fluid escapes through a small tear or hole in the outermost layer of tissue that surrounds the brain or the spinal cord. Specialized tests such as myelography, which takes images of the spine, spinal cord and surrounding structures to look for abnormalities A cerebrospinal fluid (CSF) leak happens when there is a tear in the membrane (dura) that contains the fluid.Whether the hole or tear is in the cranial area or the spine, the physician can order imaging tests to determine the exact location of the leak. The patient’s physician also may order tests to examine the condition of the brain and spinal cord. If the discharge can be collected, it is sent for laboratory tests to determine if it is cerebrospinal fluid. If a cranial CSF leak is suspected, the patient’s physician may ask them to lean forward so they can observe if this increases the flow of nasal discharge. Experts such as those in the Cedars-Sinai CSF Leak Program can be pivotal in providing relief. A CSF leak can be difficult to detect, causing misdiagnosis or delayed diagnosis. How is a cerebrospinal fluid leak diagnosed?ĭiagnosis of a CSF leak generally begins with a physical exam and history.
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