Cerebrospinal Fluid Leak

Cerebrospinal fluid (CSF) is a clear liquid that surrounds the spine and brain, providing a cushion against the skull. This fluid is held in place by a membrane (meninges), but if that membrane tears, the fluid can leak out. There are several reasons that the membrane might tear, including surgery, injury to the head or spine, or improperly formed, fragile skull bones. Conditions that cause CSF to build up – such as a tumor – can increase pressure on the membrane, causing it to weaken.



Cerebrospinal fluid leak symptoms occur when the cerebrospinal fluid drains, or leaks, and the brain starts to rest directly on the skull, without cushioning, causing headaches that get worse with sitting or standing, and get better when lying down. 

Left untreated, a cerebrospinal fluid leak can lead to a serious infection called meningitis.


Tests, such as CT or MRI scans, may be used to confirm a CSF leak and to find where the leak is located. Dye, or contrast, may need to be injected into the CSF through the low back before the scan in order to find the site of leak.

In some cases, fluid may drain from the ears, nose or a wound in the head or spine. If this happens, a doctor may test the fluid in order to confirm that it’s cerebrospinal fluid.

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Treatment Options

Dr. Amin Kassam, vice president for Neurosciences at Aurora Health Care, explains the Expanded Endonasal Approach, a minimally invasive surgery technique.

CSF leaks often repair themselves, particularly if they’re caused by an injury. This can take as little as a week and as long as six months. Treatment may include rest and pain relievers for headaches.

If the leakage continues, though, a doctor may perform a blood patch to repair the leak. In this procedure, your own blood is injected near the site of the tear, where it forms a patch and blocks the fluid from draining out. 

If surgery is required, your surgeon may use the Expanded Endonasal Approach (EEA), a minimally invasive procedure in which the leak is accessed through the nasal passages and repaired, resulting in no incisions, a shorter hospital stay and faster recovery than traditional brain surgery.

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