Progression and Potential Complications of Cerebrospinal Fluid (CSF) Leaks

What is a CSF leak?

The brain and spinal cord are protected by three membranes (meninges). When the outermost layer of the meninges, the dura, is injured or punctured — often as a result of a head injury, certain medical procedures, or an increase of pressure in the skull — a cerebrospinal fluid (CSF) leak may occur. Cerebrospinal fluid is a clear liquid that flows in and around the brain and spinal cord to protect from injury and transfer nutrients.

Cerebrospinal fluid leaks are categorized according to the location of the leak: Spinal CSF leaks originate from the dura around the spinal column, whereas cranial CSF leaks originate from the dura around the skull. Symptoms of a CSF leak vary and may include headache, tinnitus, nasal drainage, ear drainage, dizziness, nausea, and/or behavioral changes.

Progression of CSF leaks

CSF leaks are typically very treatable. Approximately 98% of individuals will recover from CSF leaks regardless of the cause.

Chronic or untreated CSF leaks can cause the following symptoms:

• Headache
• Neck pain
• Ringing in the ears (tinnitus)
• Loss of taste or smell
• Meningitis or other life-threatening brain infections

Potential complications of CSF leaks

Potential complications of CSF leaks include the following:

• Meningitis
• Encephalitis
• Tension pneumocephalus (air entering the space surrounding the brain)
• Subdural hematomas (bleeding on the surface of the brain)
• Damage to the brain parenchyma (the functional tissue in the brain)
• Coma

Additional source: Spinal CSF Leak Foundation