Rapid Treatment for a Full Recovery
A
cerebrospinal fluid leak is a condition in which the protective fluid
surrounding the brain – the CSF – leaks into the sinuses or the ears.
Normally
the brain is a sterile compartment that is separated from the sinuses and the
ears by a bony separation called the skull base. CSF surrounds the brain and
cushions it. A thick, leathery tissue called dura lines the inside of the skull,
providing a seal that prevents spinal fluid from escaping. CSF leaks occur when
there is a breakdown in this barrier.
The dura
can be damaged by certain surgeries, head trauma, and tumors. Leaks sometimes
occur spontaneously. Untreated CSF leaks can lead to life-threatening
meningitis, brain infections, or stroke.
UT
Southwestern specialists offer rapid, accurate diagnosis of this dangerous
condition, world-class surgical services to correct it, and pre- and
post-surgical care that optimizes each patient’s treatment and recovery.
Symptoms
Symptoms
of a CSF leak typically include:
- A headache that worsens upon sitting up and eases upon lying down
- Clear drainage from the ear (CSF otorrhea) or the nose (CSF rhinorrhea) when
leaning forward or straining
Diagnosis
UT
Southwestern physicians might use a variety of tests to diagnose a CSF leak and
accurately pinpoint its location.
Tests
include:
Treatments for Cerebrospinal Fluid
(CSF) Leak
The
treatment of CSF leaks depends on the location of the leak. Leaks into the
sinuses can usually be repaired through minimally invasive, endoscopic procedures.
CSF leaks from the ear typically require open surgery.
Endoscopic repair of CSF
rhinorrhea (drainage from the nose)
In this
procedure, the physician accesses the leak through the patient’s nose, avoiding
an external incision. After the location of the leak has been precisely
located, small pieces of tissue from the nasal lining are placed on the site.
The
success rate of this minimally invasive procedure is 90 to 95 percent; it
carries far less risk than an open approach. But as with any surgical
procedure, endoscopic sinus surgery does have certain risks, such as:
- Bleeding, scarring, or infection
- Change in smell or taste
- Injury to the eye (loss of vision, temporary or prolonged double vision, or
eye tearing)
- Infection spreading to the brain, resulting in meningitis
Repair of CSF
otorrhea (drainage from the ear)
A CSF
leak into the ear requires traditional surgical incisions. The surgical option
depends on the location of the leak. If the leak is in the posterior fossa –
toward the back of the skull – an outpatient surgery can usually correct the
problem. A leak near the middle cranial fossa – near the center of the skull –
requires a craniotomy, for which the patient will need to spend three to four
days in the hospital.
Rehabilitation
Each patient’s
recovery plan is tailored to ensure the surgery is successful and the recovery
is complete.
Patients
who require traditional surgery will recover in the Neuroscience
Intensive Care Unit (neuro ICU) at UT Southwestern, one of the world’s premier neurological diagnostic and
treatment centers.
Postoperatively,
patients are placed on bed rest in the hospital, typically for two to three
days, to help facilitate the healing process and closely monitor for leak
recurrence. The repair site can take four to six weeks to heal completely. During
that time, the patient’s activity will be restricted to avoid straining, heavy
lifting (no greater than 10 pounds), and nose blowing.