Cerebrospinal Fluid (CSF) Leak

Cerebrospinal fluid is a colorless fluid which serves as a cushion for brain inside the skull and for spine inside the spinal cavity.  It also gives immunological and mechanical protection to the brain and the spine. Damages to the skull bones that lie beneath the brain can cause a tear to the tissue surrounding the brain known as dura. Through these tears cerebrospinal fluids may leak and these leaks may come out through nose. These cerebrospinal fluid leak can also take place as a result of a sinonasal surgery or as a result of trauma experienced by the head or ears. Leakage of brain fluid can be very serious as it can lead to meningitis which means infection to brain tissues.

Symptoms

1)      Continuous dripping of a clear fluid from the nose.

2)      Meningitis

3)      Severe headache

Diagnosis

Your medical history and a complete physical examination by the physician will be followed by an endoscopy. Endoscope is an instrument with a camera and a light source attached to one end of a flexible wire, the other end of which is attached to the monitor situated in front of the surgeon. With the help of this the surgeon will be able to view the inside of the nose and surrounding areas and find out the exact location of the leak. CT scan and MRI scan will also be conducted to obtain a detailed image of the skull and the sinuses to indentify the exact point of leak.

Treatment

Complete bed rest for several days is the first treatment option. It has been found that the cerebrospinal fluid leak has stopped and symptoms like headache have vanished as a result of bed rest. During the period of bed rest patients are advised to avoid coughing and sneezing.  Drinking of more fluids with caffeine content is also very helpful in reducing symptoms like headache. If the symptoms continue even after one week then a procedure called lumbar puncture can be followed to close the hole that caused the leakage. This procedure is also called blood patch because blood clot is used to seal the leak. In another surgical procedure which can be done through and external incision or using an endoscope a graft material taken from other parts of the body or of synthetic nature is used to close the hole. At the end of this surgery a nose patch is placed which will be removed after one week.

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