Cerebral spinal fluid leak results when the fluid around the brain (called cerebral spinal fluid) leaks through a hole through the skull bone. This fluid can either drain from the ear or the nose, depending on where the skull bone is damaged.
Patients typically complain of clear, watery drainage usually from only one side of the nose or one ear. Drainage can increase with tilting the head forward or straining. Other symptoms can include headache, vision changes, and hearing loss. CSF leaks can be separated into two groups. Spontaneous leaks occur without any known cause. Traumatic leaks are most commonly related to a history of head injury, surgery, or tumors.
Treatment can be either medical or surgical. Conservative treatment is usually recommended first in cases of spontaneous CSF leak or head trauma. This includes 1-2 weeks of bed rest. Patients are encouraged to avoid coughing, sneezing, and heavy lifting. Straining is avoided by taking stool softeners.
Surgical treatment of CSF leaks is used when conservative treatment fails. The approach can be either through an external incision or endoscopic. During surgery, graft material is placed to close the hole in the skull base.
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