Materiały źródłowe

• #1 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  A cerebrospinal fluid leak can affect many body systems, including balance, vision, hearing, brain function and more. […] Spontaneous CSF leaks are more likely in people over 30 (the average age to have them is 42). Females are also much more likely to develop spontaneous CSF leaks. […] Having a CSF leak causes a drop in fluid pressure inside your head. That causes a condition known as intracranial hypotension (intracranial means inside your skull and hypotension means lower than normal pressure). Intracranial hypotension is a rare condition, and about 5 people out of every 100,000 have it. […] However, it’s very likely that CSF leaks happen more often than that number suggests. Experts don’t know exactly how common CSF leaks are because they’re difficult to diagnose. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons.

• #2 Cerebrospinal Fluid Leak | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 49

  https://www.barrowneuro.org/condition/cerebrospinal-fluid-leak/

  A cerebrospinal fluid CSF leak, or CSF leak for short, is an escape of the colorless fluid that surrounds and protects the brain from the skull and spinal cord from the thecal sac (the tough covering surrounding the spinal cord) in the spine. […] CSF leaks are rare. They occur at a rate of approximately two to five cases for every 100,000 people, though this number is thought to be an underestimate. […] CSF leaks occur at a rate of approximately five cases for every 100,000 people, though this number is thought to be an underestimate.

• #3 Cerebrospinal Fluid Leak | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 49

  https://www.barrowneuro.org/condition/cerebrospinal-fluid-leak/

  A cerebrospinal fluid CSF leak, or CSF leak for short, is an escape of the colorless fluid that surrounds and protects the brain from the skull and spinal cord from the thecal sac (the tough covering surrounding the spinal cord) in the spine. […] CSF leaks are rare. They occur at a rate of approximately two to five cases for every 100,000 people, though this number is thought to be an underestimate. […] CSF leaks occur at a rate of approximately five cases for every 100,000 people, though this number is thought to be an underestimate.

• #4 What is a CSF Leak? | CSF Leak Association

  https://csfleak.uk/resource/what-is-a-csf-leak

  Spontaneous spinal CSF leaks, where the onset of symptoms comes out of the blue, were once considered rare, but are now known to be far more prevalent than first thought. Such leaks are increasingly attributed to an underlying congenital disorder, such as the Ehlers-Danlos Syndromes and other connective tissue diseases. […] While knowledge of CSF leaks may be limited within the general public and some sectors of the medical profession, such as general practice and emergency medicine, they are not uncommon and spontaneous CSF leaks affect at least 5 in 100,000 people every year.

• #5 Cerebrospinal fluid leak – Wikipedia

  https://en.wikipedia.org/wiki/Cerebrospinal_fluid_leak

  A 1994 community-based study indicated that two out of every 100,000 people with a sCSF, while a 2004 emergency room-based study indicated five per 100,000. sCSF leaks generally affect the young and middle aged; the average age for onset is 42.3 years, but onset can range from ages 22 to 61. In an 11-year study, women were found to be twice as likely to be affected as men. […] Studies have shown that sCSF leaks runs in families. It is suspected that genetic similarity in families includes weakness in the dura mater which leads to a sCSFL. Large scale population-based studies have not yet been conducted. While a majority of sCSF leaks continue to be undiagnosed or misdiagnosed, an actual increase in occurrence is unlikely.

• #6 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  A cerebrospinal fluid leak can affect many body systems, including balance, vision, hearing, brain function and more. […] Spontaneous CSF leaks are more likely in people over 30 (the average age to have them is 42). Females are also much more likely to develop spontaneous CSF leaks. […] Having a CSF leak causes a drop in fluid pressure inside your head. That causes a condition known as intracranial hypotension (intracranial means inside your skull and hypotension means lower than normal pressure). Intracranial hypotension is a rare condition, and about 5 people out of every 100,000 have it. […] However, it’s very likely that CSF leaks happen more often than that number suggests. Experts don’t know exactly how common CSF leaks are because they’re difficult to diagnose. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons.

• #7 :: KJNT :: Korean Journal of Neurotrauma

  https://kjnt.org/DOIx.php?id=10.13004/kjnt.2017.13.2.63

  Cerebrospinal fluid (CSF) leaks are one of the common complications after traumatic brain injuries (TBI). […] Post-traumatic CSF leaks are seen 1% to 3% of all closed traumatic brain injuries (TBI) in adults and 80% to 90% of all the causes of CSF leaks in adult patients are due to head injuries. […] The risk of meningitis from the traumatic CSF leak can present with high morbidity and even mortality depending on the cause and site of CSF leak. […] The traditional treatment involves intravenous antibiotics treatment as well as primary repair of dural defect if the definite injury is suspected. […] The timing of CSF leak is important that it will affect the long-term prognosis of the patients with other complications such as infection. […] The early onset group includes the patients with CSF leak within 48 hours from trauma.

• #8 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #9 Spinal Cerebrospinal Fluid (CSF) Leaks | MedStar Health

  https://www.medstarhealth.org/services/spinal-cerebrospinal-fluid-leaks

  We’re one of few multidisciplinary teams trained to find and repair spinal cerebrospinal fluid (CSF) leaks. […] With advances in imaging, this diagnosis is now more common than previously recognized. […] Anyone can develop a spinal CSF leak, although they most commonly occur in adults between 20 to 60. We continue investigating risk factors for this condition. […] Because many spinal CSF leaks occur spontaneously and providers may be unfamiliar with the condition, it’s often misdiagnosed, or diagnosis is delayed. An accurate and timely diagnosis requires skilled providers who are familiar with the signs and symptoms of spinal CSF leaks. […] Treatment is essential because low pressure in the brain can lead to worsening neurologic symptoms. […] Spontaneous leaks can be challenging to treat, potentially requiring several procedures over time. The most effective treatment begins with having the correct diagnosis, and we take the time upfront to accurately determine the cause of your headache or neurologic symptoms. […] If you suspect a spinal cerebrospinal fluid leak because of a patient’s symptoms or imaging results, you should refer them to the experts at MedStar Georgetown University Hospital.

• #10 Cerebrospinal fluid leak – Wikipedia

  https://en.wikipedia.org/wiki/Cerebrospinal_fluid_leak

  A 1994 community-based study indicated that two out of every 100,000 people with a sCSF, while a 2004 emergency room-based study indicated five per 100,000. sCSF leaks generally affect the young and middle aged; the average age for onset is 42.3 years, but onset can range from ages 22 to 61. In an 11-year study, women were found to be twice as likely to be affected as men. […] Studies have shown that sCSF leaks runs in families. It is suspected that genetic similarity in families includes weakness in the dura mater which leads to a sCSFL. Large scale population-based studies have not yet been conducted. While a majority of sCSF leaks continue to be undiagnosed or misdiagnosed, an actual increase in occurrence is unlikely.

• #11 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #12 Cerebrospinal fluid leak – Wikipedia

  https://en.wikipedia.org/wiki/Cerebrospinal_fluid_leak

  A 1994 community-based study indicated that two out of every 100,000 people with a sCSF, while a 2004 emergency room-based study indicated five per 100,000. sCSF leaks generally affect the young and middle aged; the average age for onset is 42.3 years, but onset can range from ages 22 to 61. In an 11-year study, women were found to be twice as likely to be affected as men. […] Studies have shown that sCSF leaks runs in families. It is suspected that genetic similarity in families includes weakness in the dura mater which leads to a sCSFL. Large scale population-based studies have not yet been conducted. While a majority of sCSF leaks continue to be undiagnosed or misdiagnosed, an actual increase in occurrence is unlikely.

• #13 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  A cerebrospinal fluid leak can affect many body systems, including balance, vision, hearing, brain function and more. […] Spontaneous CSF leaks are more likely in people over 30 (the average age to have them is 42). Females are also much more likely to develop spontaneous CSF leaks. […] Having a CSF leak causes a drop in fluid pressure inside your head. That causes a condition known as intracranial hypotension (intracranial means inside your skull and hypotension means lower than normal pressure). Intracranial hypotension is a rare condition, and about 5 people out of every 100,000 have it. […] However, it’s very likely that CSF leaks happen more often than that number suggests. Experts don’t know exactly how common CSF leaks are because they’re difficult to diagnose. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons.

• #14 The Management of Cranial and Spinal CSF Leaks – Barrow Neurological Institute

  https://www.barrowneuro.org/for-physicians-researchers/education/grand-rounds-publications-media/barrow-quarterly/volume-17-no-4-2001/the-management-of-cranial-and-spinal-csf-leaks/

  The demographics of this population of patients parallel those of the trauma statistics, with the majority of cases involving young adult males, 18 to 25 years of age. […] Nontraumatic or spontaneous CSF leaks are much less common than their traumatic counterparts. […] The occurrence of meningitis is rare but may be the only clue to diagnosis. […] CSF leaks complicate 10 to 20% of the resections of cerebellopontine angle tumors, particularly if the approach involves extensive drilling of the petrous-temporal bone. […] The management of spontaneous spinal CSF leaks begins with fluid replacement and bed rest to relieve the symptoms of intracranial hypotension.

• #15 Cerebrospinal Fluid Leak | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/csf-leak/

  At UT Southwestern Medical Center, patients can expect an accurate diagnosis for cerebrospinal fluid (CSF) leaks as well as access to the newest surgical and minimally invasive treatments for this potentially life-threatening condition. […] A CSF leak of the skull base is a condition in which the clear fluid that surrounds and cushions the brain leaks out of the skull through a defect or hole in the base of the skull. If left untreated, a CSF leak can cause serious complications, such as meningitis. […] Although trauma, surgery, and tumors can cause CSF leaks, they most commonly occur without any history of these risk factors. […] Without a history of these risk factors, the leak is considered idiopathic, which means there is no known cause for the leak. However, CSF leaks are more common in patients with: Obesity, Chronically elevated CSF pressure, Obstructive sleep apnea.

• #16 CSF leak (Cerebrospinal fluid leak) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. […] A spinal CSF leak occurs anywhere in the spinal column. […] A cranial CSF leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear. […] Some CSF leaks may heal with bed rest and other conservative treatment. Many CSF leaks need a patch to cover the hole or surgery to repair the leak. […] Risk factors for spinal CSF leaks include having a previous surgery or procedure on or around the spine. […] Risk factors for cranial CSF leaks include having a previous surgery on or around the skull. […] If a cranial CSF leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain. Untreated spinal CSF leaks may lead to subdural hematomas, or bleeding on the surface of the brain.

• #17 Cerebrospinal Fluid (CSF) Leak | Choose the Right Test

  https://arupconsult.com/content/csf-leak-beta-2-transferrin

  Spontaneous cerebrospinal fluid (CSF) leaks have been reported in association with heritable connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome. CSF leaks are thought to occur because of the fragility of connective tissue in these disorders. Some investigators suggest that all patients with spontaneous CSF leaks be evaluated for connective tissue and vascular anomalies. […] Unlike cranial cerebrospinal fluid (CSF) leaks, which can often be confirmed with laboratory testing, spinal CSF leaks are diagnosed with imaging. In patients with chronic, unresolved symptoms suggestive of intracranial hypotension without another overt cause, magnetic resonance imaging (MRI) or digital subtraction myelography can be used to confirm the existence and location of a spinal CSF leak.

• #18 Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study | European Journal of Human Genetics

  https://www.nature.com/articles/ejhg2012191

  We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. […] We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities. […] The prevalence of HDCT in patient with spontaneous CSF leaks has been rarely estimated. […] The recognition of HDCT in patients with spontaneous CSF leaks may be important mainly because of the potential vascular (and other connective tissue) fragility that is associated with them. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of HDCT, and that individuals with spontaneous CSF leaks should be evaluated for connective tissue and vascular abnormalities.

• #19 Cerebrospinal fluid leak – Wikipedia

  https://en.wikipedia.org/wiki/Cerebrospinal_fluid_leak

  A 1994 community-based study indicated that two out of every 100,000 people with a sCSF, while a 2004 emergency room-based study indicated five per 100,000. sCSF leaks generally affect the young and middle aged; the average age for onset is 42.3 years, but onset can range from ages 22 to 61. In an 11-year study, women were found to be twice as likely to be affected as men. […] Studies have shown that sCSF leaks runs in families. It is suspected that genetic similarity in families includes weakness in the dura mater which leads to a sCSFL. Large scale population-based studies have not yet been conducted. While a majority of sCSF leaks continue to be undiagnosed or misdiagnosed, an actual increase in occurrence is unlikely.

• #20 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #21 Cerebrospinal Fluid Leak Imaging: Practice Essentials, Computed Tomography, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/338989-overview

  Cerebrospinal fluid (CSF) leak may occur from the nose (rhinorrhea), from the external auditory canal (otorrhea), or from a traumatic or operative defect in the skull or spine. CSF leaks occur when there is a tear or hole in the dura mater, which is the outermost layer of the meninges that protects the central nervous system. According to Ommaya et al, 80% of CSF leaks are due to nonsurgical trauma, 16% are iatrogenic, and 4% are spontaneous. The most common locations of a CSF leak are the upper thoracic level (T1-T6) and the lower thoracic level (T7-T12). […] Traumatic CSF leak is reported in approximately 10-30% of skull base fractures in adults. More than half of these present within 48 hours. The most common fracture sites leading to CSF leaks are the frontal sinus (30.8%), sphenoid sinus (11.4-30.8%), ethmoid (15.4-19.1%), cribriform plate (7.7%), frontoethmoid (7.7%), and sphenoethmoid (7.7%).

• #22 Spontaneous cerebrospinal fluid rhinorrhoea: a case report and literature review | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-024-04882-9

  Cerebrospinal fluid rhinorrhea is a rare condition characterized by the abnormal leakage of cerebrospinal fluid from the intracranial space into the sinonasal cavity. It includes various etiologies, including traumatic, iatrogenic, and spontaneous causes, each with distinct epidemiological and clinical characteristics. […] The epidemiology of CSF rhinorrhea varies on the basis of its etiology. A recent systematic review revealed that traumatic CSF rhinorrhea constitutes 44% of cases, iatrogenic CSF rhinorrhea accounts for 12%, and spontaneous CSF rhinorrhea makes up 28% of cases. […] This condition poses considerable risks, such as meningitis, if left untreated. […] Early detection and prompt intervention are paramount to prevent complications, particularly the risk of meningitis.

• #23 CSF leak (Cerebrospinal fluid leak) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. […] A spinal CSF leak occurs anywhere in the spinal column. […] A cranial CSF leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear. […] Some CSF leaks may heal with bed rest and other conservative treatment. Many CSF leaks need a patch to cover the hole or surgery to repair the leak. […] Risk factors for spinal CSF leaks include having a previous surgery or procedure on or around the spine. […] Risk factors for cranial CSF leaks include having a previous surgery on or around the skull. […] If a cranial CSF leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain. Untreated spinal CSF leaks may lead to subdural hematomas, or bleeding on the surface of the brain.

• #24 CSF leak (Cerebrospinal fluid leak) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/csf-leak-cerebrospinal-fluid-leak

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. […] A spinal CSF leak occurs anywhere in the spinal column. […] A cranial CSF leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear. […] Some CSF leaks may heal with bed rest and other conservative treatment. Many CSF leaks need a patch to cover the hole or surgery to repair the leak. […] Risk factors for spinal CSF leaks include having a previous surgery or procedure on or around the spine. […] Risk factors for cranial CSF leaks include having a previous surgery on or around the skull. […] If a cranial CSF leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain.

• #25 Cerebrospinal Fluid Leak Imaging: Practice Essentials, Computed Tomography, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/338989-overview

  Cerebrospinal fluid (CSF) leak may occur from the nose (rhinorrhea), from the external auditory canal (otorrhea), or from a traumatic or operative defect in the skull or spine. CSF leaks occur when there is a tear or hole in the dura mater, which is the outermost layer of the meninges that protects the central nervous system. According to Ommaya et al, 80% of CSF leaks are due to nonsurgical trauma, 16% are iatrogenic, and 4% are spontaneous. The most common locations of a CSF leak are the upper thoracic level (T1-T6) and the lower thoracic level (T7-T12). […] Traumatic CSF leak is reported in approximately 10-30% of skull base fractures in adults. More than half of these present within 48 hours. The most common fracture sites leading to CSF leaks are the frontal sinus (30.8%), sphenoid sinus (11.4-30.8%), ethmoid (15.4-19.1%), cribriform plate (7.7%), frontoethmoid (7.7%), and sphenoethmoid (7.7%).

• #26 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #27 Cerebrospinal Fluid Leak Imaging: Practice Essentials, Computed Tomography, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/338989-overview

  Cerebrospinal fluid (CSF) leak may occur from the nose (rhinorrhea), from the external auditory canal (otorrhea), or from a traumatic or operative defect in the skull or spine. CSF leaks occur when there is a tear or hole in the dura mater, which is the outermost layer of the meninges that protects the central nervous system. According to Ommaya et al, 80% of CSF leaks are due to nonsurgical trauma, 16% are iatrogenic, and 4% are spontaneous. The most common locations of a CSF leak are the upper thoracic level (T1-T6) and the lower thoracic level (T7-T12). […] Traumatic CSF leak is reported in approximately 10-30% of skull base fractures in adults. More than half of these present within 48 hours. The most common fracture sites leading to CSF leaks are the frontal sinus (30.8%), sphenoid sinus (11.4-30.8%), ethmoid (15.4-19.1%), cribriform plate (7.7%), frontoethmoid (7.7%), and sphenoethmoid (7.7%).

• #28 Spontaneous Spinal CSF Leaks Stratified by Age, Body Mass Index, and Spinal Level | American Journal of Neuroradiology

  http://www.ajnr.org/content/43/7/1068

  There are 3 main types of spinal CSF leaks, and the imaging appearances are well-reported. Specific patient demographics and spinal locations of the various types of spinal leaks are less frequently described. The purpose of this article was to stratify the various types of spontaneous CSF leaks on the basis of age, body mass index, and spinal level. […] Sixty-five patients (37 women and 28 men) had spinal CSF leaks. Type 1 CSF leaks (dural tears) were observed in 25 patients (mean age, 44.5years; mean body mass index, 24.3) and were most common in the upper thoracic spine (72%), particularly at the T1T2 level (36%). Type 2 CSF leaks (ruptured meningeal diverticula) were observed in 4 patients (mean age, 45.5years; mean body mass index, 27.5) and were all seen in the lower thoracic spine. Type 3 CSF leaks (CSF-venous fistulas) were observed in 36 patients (mean age, 58.8years; mean body mass index, 27.0) and were most common on the right side (72%) and in the lower thoracic spine (56%).

• #29 Symptoms of a Spinal CSF Leak | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/csf-leaks/symptoms-spinal-csf-leak

  Spontaneous intracranial hypotension is a syndrome that occurs from a spinal cerebrospinal fluid leak, meaning a leak of CSF from a defect in the dura around the spinal cord. […] Once the presence and location of a spinal CSF leak have been confirmed, the neuro-imaging specialist may perform an epidural blood patch or fibrin patch procedure and/or refer the patient to a neurosurgeon with expertise in closing these leaks. […] Three types of spinal CSF leaks. Type 1: a bone spur creates a tear in the dura. Type 2: a rupture of an outpouching of dura surrounding a nerve root. Type 3: rupture of the dura with leakage of CSF into an adjacent blood vessel (CSF-venous fistula).

• #30 Spontaneous Spinal CSF Leaks Stratified by Age, Body Mass Index, and Spinal Level | American Journal of Neuroradiology

  http://www.ajnr.org/content/43/7/1068

  Type 1 CSF leaks occurred in younger patients with a normal body mass index, while patients with type 3 CSF leaks were relatively older and had an elevated body mass index. Type 1 leaks mostly occurred in the upper thoracic spine, and types 2 and 3 leaks mostly occurred in the lower thoracic spine. […] It is known that spinal CSF leaks are more common in adults than in children and in females versus males. […] Our study shows that age, BMI, and spinal leak level vary by spinal CSF leak type. Patients with type 1 CSF leaks (dural tears) are typically younger (mean age, 44.5years) and have a normal BMI (mean, 24.3), while patients with type 3 CSF leaks (CVFs) are relatively older (mean age, 58.8years) and have an elevated BMI (mean, 27.0). […] Type 2 spinal CSF leaks were the least common in our patient population. This finding contrasts with an older study that stated that type 2 leaks were the most common type of CSF leak.

• #31 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25111523/

  Objective: To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. This condition is yet another public health problem related to the rising obesity epidemic.

• #32 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – University of Iowa

  https://iro.uiowa.edu/esploro/outputs/9984006484402771

  The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea. […] To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. […] This condition is yet another public health problem related to the rising obesity epidemic. […] All patients with spontaneous CSF leaks should be evaluated for OSA.

• #33 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25111523/

  Objective: To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. This condition is yet another public health problem related to the rising obesity epidemic.

• #34 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #35 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #36 Cerebrospinal fluid leaks after spine tumor resection: avoidance, recognition and management

  https://atm.amegroups.org/article/view/24000/html

  Post-operative CSF leaks are a known complication of spine surgery in general, and patients undergoing surgical intervention for spinal tumors may be particularly predisposed due to the presence of intradural tumor and a number of other factors. […] In this article, the incidence, risk factors and complications of CSF leaks after spine tumor surgery are reviewed, with an emphasis on avoidance of post-operative CSF leaks, early post-operative identification and effective secondary intervention. […] Patients undergoing surgical intervention for spinal tumors would seem particularly prone to the development of post-operative CSF leaks due to a number of factors, including: (I) the variable presence of an intradural tumor component requiring durotomy as a part of the intervention, (II) deficits in wound healing capability as a result of malnutrition, complex wounds, medical comorbidities, extended use of high-dose steroids or the need for adjuvant chemoradiotherapy, and (III) the use of anterior/ventral approaches to the spine which may create communications between the subarachnoid space and negative pressure potential spaces (e.g., the pleural cavity).

• #37 Cerebrospinal fluid leaks after spine tumor resection: avoidance, recognition and management

  https://atm.amegroups.org/article/view/24000/html

  The reported incidence of CSF leak requiring intervention after spinal tumor surgery varies widely (028.6%), but a review of the recent literature would suggest that the overall incidence after surgery for both intradural and extradural pathologies is relatively low. […] Risk factors for the development of post-operative CSF leak requiring intervention after spine surgery, however, are not well defined. […] Several authors have suggested that minimally invasive surgical (MIS) approaches to spine tumor resection and other MIS spine surgeries lead to lower rates of post-operative symptomatic CSF leakage, despite the increased difficulty of primary dural closure through an MIS approach. […] The goal of this article will be to review the literature on post-operative CSF leaks after surgical intervention for spinal tumors with an emphasis on avoidance, recognition and effective management.

• #38 Cerebrospinal Fluid Leak Imaging: Practice Essentials, Computed Tomography, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/338989-overview

  Cerebrospinal fluid (CSF) leak may occur from the nose (rhinorrhea), from the external auditory canal (otorrhea), or from a traumatic or operative defect in the skull or spine. CSF leaks occur when there is a tear or hole in the dura mater, which is the outermost layer of the meninges that protects the central nervous system. According to Ommaya et al, 80% of CSF leaks are due to nonsurgical trauma, 16% are iatrogenic, and 4% are spontaneous. The most common locations of a CSF leak are the upper thoracic level (T1-T6) and the lower thoracic level (T7-T12). […] Traumatic CSF leak is reported in approximately 10-30% of skull base fractures in adults. More than half of these present within 48 hours. The most common fracture sites leading to CSF leaks are the frontal sinus (30.8%), sphenoid sinus (11.4-30.8%), ethmoid (15.4-19.1%), cribriform plate (7.7%), frontoethmoid (7.7%), and sphenoethmoid (7.7%).

• #39 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538157/

  Cerebrospinal fluid (CSF) leak is the escape of the fluid surrounding the brain and spinal cord. According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. It is known that spontaneous spinal CSF leaks are more common in female adults than in children. The average patient age at the presentation for various types of spontaneous CSF leaks ranges from 33 years (+/-10) to 52.4 years (+/-13.1). Its most common location is at the upper thoracic level (T1 – T6), followed by the lower thoracic level (T7 – T12), and being the lumbar and cervical spine levels the less common regions. Nearly 2.8 million people in the United States sustained a head injury that resulted in an emergency department visit, hospitalization, or death between 2007 and 2013. Skull base fractures occur in approximately 4% of these injuries, accounting for 21% of all skull fractures. The widely cited incidence of CSF leaks resulting from skull base fractures has been reported in the literature as 10 to 30%. Still, recently the retrospective study from the Harward group reviewed the incidence of CSF leaks among 4,944 patients with cranial facial fractures and reported a lower incidence of 4%. A cerebrospinal fluid leak is also a known complication of post-trauma surgical procedures, endoscopic endonasal skull base surgery, operations involving the lumbosacral spine, as well as diagnostic or therapeutic lumbar puncture. The CSF leak incidence after primary spine surgery varies from 5.5% to 9% and 13.2% to 21% for second-look surgeries. Non-identified intraoperative durotomies occurred in 6.8% of cases, and the incidence of CSF leaks was less frequent in minimally invasive surgeries (4.7%) compared to 9.0% of open cases, according to Wong et al.

• #40 CSF Otorrhea: Practice Essentials, Epidemiology, Etiology

  https://emedicine.medscape.com/article/883160-overview

  Leakage of cerebrospinal fluid (CSF) though the ear structures is a rare but potentially life-threatening situation that requires rapid intervention. […] Because this problem is so rare, the exact frequency with which it occurs is unknown. Leaks as a postoperative complication of skull base surgery represent the bulk of cases. This complication has been reported to occur in 6-12% of such cases. Leakage as a result of temporal bone fracture is the second most common etiology and occurs in 21% of patients with temporal bone fractures. Spontaneous leakage is rare, with less than 500 cases having been reported in the literature worldwide. Such leakage is more common in children (72%) than adults. […] Using the MarketScan Commercial Claims and Encounters Database (Truven Health Analytics), Varshneya et al found that a CSF leak occurred in 202 of 13,861 pediatric patients with skull fracture (1.46%). That included 118 patients (58.4%) who presented with otorrhea, and 84 patients (41.6%) who presented with rhinorrhea.

• #41 Cerebrospinal Fluid (CSF) Leak: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/ochspine/cerebrospinal-fluid-csf-leak

  Cerebrospinal fluid (CSF) leaks are considered a rare but serious condition. […] Cerebrospinal fluid leaks are a rare but serious condition that may lead to long-term side effects or health complications if left untreated. […] There are several known risk factors for cerebrospinal leaks. […] If the condition is left untreated, complications can develop from a chronic or ongoing CSF leak.

• #42 :: KJNT :: Korean Journal of Neurotrauma

  https://kjnt.org/DOIx.php?id=10.13004/kjnt.2017.13.2.63

  The delayed onset group is defined as patients with CSF leak presented at least 1 week after trauma. […] Meningitis is seen in 19% of persistent CSF leakage with 10% of mortality. […] The delayed CSF leakage and the longer duration of the leakage with concomitant infection have a higher risk of meningitis. […] The most common pathogens of meningitis due to CSF leakage are Streptococcus pneumoniae and Hemophilus influenza. […] The indications for early surgery is as follows: 1) penetrating injury; 2) intracranial hematoma; 3) meningitis; 4) large intracranial aerocele; 5) herniation of brain tissue from nose and ear; and 6) low probability of natural dural repair. […] The indications of delated surgery are as follows: 1) persistent CSF leakage after 10 days of conservative management; 2) recurrence of delayed CSF leakage after 10 days of conservative management; 3) recurrent aerocels after 10 days of conservative management; and 4) the presence of meningitis and abscess formation. […] The successful management of CSF diversion is critical for the prognosis of patients.

• #43 :: KJNT :: Korean Journal of Neurotrauma

  https://kjnt.org/DOIx.php?id=10.13004/kjnt.2017.13.2.63

  The delayed onset group is defined as patients with CSF leak presented at least 1 week after trauma. […] Meningitis is seen in 19% of persistent CSF leakage with 10% of mortality. […] The delayed CSF leakage and the longer duration of the leakage with concomitant infection have a higher risk of meningitis. […] The most common pathogens of meningitis due to CSF leakage are Streptococcus pneumoniae and Hemophilus influenza. […] The indications for early surgery is as follows: 1) penetrating injury; 2) intracranial hematoma; 3) meningitis; 4) large intracranial aerocele; 5) herniation of brain tissue from nose and ear; and 6) low probability of natural dural repair. […] The indications of delated surgery are as follows: 1) persistent CSF leakage after 10 days of conservative management; 2) recurrence of delayed CSF leakage after 10 days of conservative management; 3) recurrent aerocels after 10 days of conservative management; and 4) the presence of meningitis and abscess formation. […] The successful management of CSF diversion is critical for the prognosis of patients.

• #44 :: KJNT :: Korean Journal of Neurotrauma

  https://kjnt.org/DOIx.php?id=10.13004/kjnt.2017.13.2.63

  The delayed onset group is defined as patients with CSF leak presented at least 1 week after trauma. […] Meningitis is seen in 19% of persistent CSF leakage with 10% of mortality. […] The delayed CSF leakage and the longer duration of the leakage with concomitant infection have a higher risk of meningitis. […] The most common pathogens of meningitis due to CSF leakage are Streptococcus pneumoniae and Hemophilus influenza. […] The indications for early surgery is as follows: 1) penetrating injury; 2) intracranial hematoma; 3) meningitis; 4) large intracranial aerocele; 5) herniation of brain tissue from nose and ear; and 6) low probability of natural dural repair. […] The indications of delated surgery are as follows: 1) persistent CSF leakage after 10 days of conservative management; 2) recurrence of delayed CSF leakage after 10 days of conservative management; 3) recurrent aerocels after 10 days of conservative management; and 4) the presence of meningitis and abscess formation. […] The successful management of CSF diversion is critical for the prognosis of patients.

• #45 CSF leak (Cerebrospinal fluid leak) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. […] A spinal CSF leak occurs anywhere in the spinal column. […] A cranial CSF leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear. […] Some CSF leaks may heal with bed rest and other conservative treatment. Many CSF leaks need a patch to cover the hole or surgery to repair the leak. […] Risk factors for spinal CSF leaks include having a previous surgery or procedure on or around the spine. […] Risk factors for cranial CSF leaks include having a previous surgery on or around the skull. […] If a cranial CSF leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain. Untreated spinal CSF leaks may lead to subdural hematomas, or bleeding on the surface of the brain.

• #46 CSF leak (Cerebrospinal fluid leak) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/csf-leak-cerebrospinal-fluid-leak

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. […] A spinal CSF leak occurs anywhere in the spinal column. […] A cranial CSF leak occurs in the skull, and often causes symptoms such as clear fluid leaking from the nose or ear. […] Some CSF leaks may heal with bed rest and other conservative treatment. Many CSF leaks need a patch to cover the hole or surgery to repair the leak. […] Risk factors for spinal CSF leaks include having a previous surgery or procedure on or around the spine. […] Risk factors for cranial CSF leaks include having a previous surgery on or around the skull. […] If a cranial CSF leak is left untreated, complications may occur. Possible complications include meningitis and tension pneumocephalus, which is when air enters the spaces surrounding the brain.

• #47 CSF Otorrhea: Practice Essentials, Epidemiology, Etiology

  https://emedicine.medscape.com/article/883160-overview

  Meningitis is often the presenting symptom of CSF otorrhea. It is found in 93% of children and 36% of adults with spontaneous CSF leakage. Sensorineural hearing loss is another significant morbidity associated with spontaneous leaks in children and is present 82% of the time. Seizures are also a potential morbidity.

• #48 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  CSF leak is not contagious. You cant give it to or get it from others. […] CSF leaks are sometimes tricky to diagnose, but the overall outlook for this condition is good. While the symptoms can be unpleasant, severe or disruptive, this condition is usually treatable. The overwhelming majority of people who have CSF leaks will either recover when the leak heals or with treatments or surgeries. […] Overall, the outlook for CSF leaks is very good. About 98% of people with CSF leaks will recover from them, no matter the cause.

• #49 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  CSF leak is not contagious. You cant give it to or get it from others. […] CSF leaks are sometimes tricky to diagnose, but the overall outlook for this condition is good. While the symptoms can be unpleasant, severe or disruptive, this condition is usually treatable. The overwhelming majority of people who have CSF leaks will either recover when the leak heals or with treatments or surgeries. […] Overall, the outlook for CSF leaks is very good. About 98% of people with CSF leaks will recover from them, no matter the cause.

• #50 Why Does a Cerebrospinal Fluid (CSF) Leak Cause a Headache?

  https://www.healthline.com/health/csf-leak-headache

  Headaches are among the most common symptoms of a cerebrospinal fluid (CSF) leak. They may develop due to nerve irritation in your meninges. […] CSF leaks usually occur when the outer layer of your meninges, called the dura, experiences a puncture during surgery or from a head injury. Your meninges are three protective tissue layers covering your brain and spinal cord. […] Headaches may occur in more than 90% of people with CSF leaks. The hallmark symptom is an orthostatic headache. […] A CSF leak requires emergency medical attention. […] The outlook for a CSF leak is usually good when you manage the leak properly success rates of initial endoscopic surgery range from 87100%. […] The average time from first symptoms to diagnosis of a cerebrospinal fluid leak is 2 1/2 months. […] Most CSF leaks are treatable.

• #51 Cerebrospinal fluid leak | Neurosurgery Inselspital Bern

  https://neurochirurgie.insel.ch/en/diseases-specialities/liquor-disorders/cerebrospinal-fluid-leak

  If the CSF leak does not close after bed rest and blood patch, or in cases of large fistulas with significant symptoms, the CSF fistula is closed surgically. […] A prerequisite for surgical treatment is the preceding exact localization of the fistula. Microsurgical treatment is then very successful. As a rule, the symptoms improve significantly immediately after the procedure or have disappeared completely. Treatment at the chronic stage is more difficult, but possible. […] Given the surgeon’s proven microsurgical experience on the spinal cord and special functional monitoring during the operation, the complication rate is very low. The success rate for sealing is high, nevertheless in about 6% of patients a second operation has to be performed to close the leak completely watertight. […] Inselspital is one of the three largest centers in Europe in the special field of cerebrospinal fluid leaks and has a great deal of experience.

• #52 Cerebrospinal Fluid Leaks ENT Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/sinus/cerebrospinal-fluid-leaks/

  Cerebrospinal Fluid Leaks […] Although a cerebrospinal fluid leak is uncommon, the CSF can leak through the brain covering and into the nose area. […] CSF leaks can also be linked to meningoencephalocele this is a uncommon condition that is present at birth. […] Occasionally leaks happen in overweight individuals who have a high amount of cranial pressure. […] This condition can be very dangerous and these leaks must be mended in order to avoid an infection of the CSF (meningitis) or of the brain in general (brain abscess). […] Initially, up to 94% of CSF leaks are misdiagnosed. […] The most typical tests used for diagnosing CSF leak are done through an examination from an ear, nose and throat (ENT) specialist. […] Surgical treatment of CSF leaks is a method that is used when moderate treatment methods fail.

• #53 Why Does a Cerebrospinal Fluid (CSF) Leak Cause a Headache?

  https://www.healthline.com/health/csf-leak-headache

  Headaches are among the most common symptoms of a cerebrospinal fluid (CSF) leak. They may develop due to nerve irritation in your meninges. […] CSF leaks usually occur when the outer layer of your meninges, called the dura, experiences a puncture during surgery or from a head injury. Your meninges are three protective tissue layers covering your brain and spinal cord. […] Headaches may occur in more than 90% of people with CSF leaks. The hallmark symptom is an orthostatic headache. […] A CSF leak requires emergency medical attention. […] The outlook for a CSF leak is usually good when you manage the leak properly success rates of initial endoscopic surgery range from 87100%. […] The average time from first symptoms to diagnosis of a cerebrospinal fluid leak is 2 1/2 months. […] Most CSF leaks are treatable.

• #54 CSF Leak: Symptoms, Treatment, and Long-Term Effects in Australia

  https://brainfoundation.org.au/disorders/spinal-cerebrospinal-fluid-csf-leak/

  A spinal cerebrospinal fluid (CSF) leak is an underdiagnosed cause of a debilitating headache that is treatable. […] A variety of causes for spontaneous leaks have been identified. […] Unfortunately, this condition and the symptoms that accompany it can often be misdiagnosed as migraine, sinusitis, tension headache, post traumatic headache and the new entity of chronic daily persistent headache, especially in the case of spontaneous CSF Leaks. […] Initial diagnosis is usually suspected on the clinical presentation. […] Unfortunately, leaks are not always detected during imaging (choice and method of imaging technique and/or the nature of intermittent leaks) and may need to be repeated. […] CSF leaks are treatable in many instances. Most cases the outcomes are favourable when in experienced hands and detected early. Many patients however do not receive timely or appropriate care and this may effect outcomes.

• #55 Cerebrospinal Fluid (CSF) Leak: What to Know

  https://www.webmd.com/brain/what-is-csf-leak

  Cerebrospinal leaks are rare. According to experts, they happen to about five in every 100,000 people. But the number could be higher. They’re more common among people in their 30s and 40s. […] Women are more likely to have a CSF leak, as are people who have a history of surgery in and around the spine, obesity, obstructive sleep apnea or high blood pressure, a history of head trauma, a tumor at the skull base, or an abnormal skull base or inner ear. […] If left untreated, a CSF leak may cause complications like meningitis, which is a condition where the protective layers around the brain become inflamed. If it persists, it can pull the brain down and tear bridging veins, causing a subdural hematoma. […] Sometimes, CSF leaks may be misdiagnosed as migraines, other headache conditions, or sinusitis.

• #56 CSF leak (Cerebrospinal fluid leak) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/diagnosis-treatment/drc-20522247

  Your healthcare professional will likely start by asking about your medical history and conducting a physical exam. […] Tests to diagnose a spinal CSF leak may include: […] MRI with gadolinium. An MRI scan uses a magnetic field and radio waves to produce detailed images of the brain, spinal cord and other areas of the body. Using MRI with gadolinium makes it easier to see any changes in the spine that result from a CSF leak. […] Radioisotope cisternography. This test involves measuring the CSF pressure and then injecting a chemical into the space surrounding the spinal cord. […] Myelography. This imaging test uses a contrast dye and X-rays or computed tomography (CT) to take detailed pictures of the spine. […] Spinal tap. This test also is called lumbar puncture. It involves placing a needle in the spinal column to measure the pressure of CSF inside the spinal column.

• #57 CSF leak (Cerebrospinal fluid leak) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/diagnosis-treatment/drc-20522247

  Your healthcare professional will likely start by asking about your medical history and conducting a physical exam. […] Tests to diagnose a spinal CSF leak may include: […] MRI with gadolinium. An MRI scan uses a magnetic field and radio waves to produce detailed images of the brain, spinal cord and other areas of the body. Using MRI with gadolinium makes it easier to see any changes in the spine that result from a CSF leak. […] Radioisotope cisternography. This test involves measuring the CSF pressure and then injecting a chemical into the space surrounding the spinal cord. […] Myelography. This imaging test uses a contrast dye and X-rays or computed tomography (CT) to take detailed pictures of the spine. […] Spinal tap. This test also is called lumbar puncture. It involves placing a needle in the spinal column to measure the pressure of CSF inside the spinal column.

• #58 CSF leak (Cerebrospinal fluid leak) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/csf-leak-cerebrospinal-fluid-leak

  Untreated spinal CSF leaks may lead to subdural hematomas, or bleeding on the surface of the brain. […] Tests to diagnose a spinal CSF leak may include magnetic resonance imaging (MRI) with gadolinium. […] Tests to diagnose a cranial CSF leak may include MRI with gadolinium. […] Some CSF leaks improve with bed rest alone, but most need treatment. […] Treatments for spinal CSF leaks may include epidural blood patch. […] Other cranial CSF leaks require surgical repair.

• #59 CSF leak (Cerebrospinal fluid leak) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/diagnosis-treatment/drc-20522247

  Tests to diagnose a cranial CSF leak may include: […] MRI with gadolinium. An MRI scan may be used to help detect a CSF leak inside the brain. […] CT cisternography. This test is considered the gold standard for diagnosing and locating cranial CSF leaks. […] Some CSF leaks improve with bed rest alone, but most need treatment. […] Treatments for spinal CSF leaks may include: […] Epidural blood patch. This treatment involves taking a sample of your own blood, then injecting it into the spinal canal. […] Fibrin sealant. Fibrin sealant is special glue made from substances in human plasma that help with blood clotting. […] Surgery. Some CSF leaks need surgery. […] Trans-venous embolization. This minimally invasive procedure is used only for CSF-venous fistulas. […] Other cranial CSF leaks require surgical repair.

• #60 Cerebrospinal Fluid (CSF) Leak | Choose the Right Test

  https://arupconsult.com/content/csf-leak-beta-2-transferrin

  Laboratory testing for a cranial CSF leak is appropriate in patients with otorrhea or rhinorrhea, particularly after trauma or surgery. […] Testing fluid from the ear or nose for -2 transferrin is the recommended method to assess patients for a cranial CSF leak because this approach is noninvasive as well as highly sensitive and specific. […] Imaging, including high-resolution computed tomography, magnetic resonance cisternography, digital subtraction myelography, or magnetic resonance imaging (MRI) with or without intrathecal contrast, is used to detect the location of confirmed cranial CSF leaks and suspected or known spinal leaks and to guide intervention.

• #61 Cerebrospinal Fluid Leak Imaging: Practice Essentials, Computed Tomography, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/338989-overview

  Leakage of CSF into the epidural space through a defect in the thecal sac has been found to be the underlying cause of almost all cases of spontaneous intracranial hypotension (SIH). Typically, the leak is caused by either spontaneous dural dehiscence or dural tears caused by degenerative causes. Generally, the goal of imaging is confirmation of the diagnosis of SIH through the visualization of a leak, as well as localization of the leak, to facilitate targeted treatment with either epidural patching or surgery. […] The incidence of CSF fistula detection varies from 22 to 100% in clinical studies. The fistula detection rate is lowest for intermittent CSF leaks. The accuracy of active fistula detection with CT cisternography is 65-85%. In one study of 45 patients, CT of the skull and facial bones with high-resolution, thin-section axial and coronal images had an accuracy of 92%, a sensitivity of 92%, and a specificity of 100% in depicting the presence or absence of CSF fistula.

• #62 Spontaneous Intracranial Hypotension: A Systematic Imaging Approach for CSF Leak Localization and Management Based on MRI and Digital Subtraction Myelography | American Journal of Neuroradiology

  http://www.ajnr.org/content/40/4/745

  BACKGROUND AND PURPOSE: Localization of the culprit CSF leak in patients with spontaneous intracranial hypotension can be difficult and is inconsistently achieved. We present a high yield systematic imaging strategy using brain and spine MRI combined with digital subtraction myelography for CSF leak localization. […] Patients positive for spinal longitudinal extradural CSF collection are best positioned prone for digital subtraction myelography and may warrant additional attempts at a directed epidural blood patch. Patients negative for spinal longitudinal extradural CSF collection are best evaluated in the decubitus positions to reveal a CSF-venous fistula, common in this population. […] The syndrome of spontaneous intracranial hypotension (SIH) is caused by leakage of CSF from the thecal sac within or along the spinal canal.

• #63 Spontaneous Intracranial Hypotension: A Systematic Imaging Approach for CSF Leak Localization and Management Based on MRI and Digital Subtraction Myelography | American Journal of Neuroradiology

  http://www.ajnr.org/content/40/4/745

  BACKGROUND AND PURPOSE: Localization of the culprit CSF leak in patients with spontaneous intracranial hypotension can be difficult and is inconsistently achieved. We present a high yield systematic imaging strategy using brain and spine MRI combined with digital subtraction myelography for CSF leak localization. […] Patients positive for spinal longitudinal extradural CSF collection are best positioned prone for digital subtraction myelography and may warrant additional attempts at a directed epidural blood patch. Patients negative for spinal longitudinal extradural CSF collection are best evaluated in the decubitus positions to reveal a CSF-venous fistula, common in this population. […] The syndrome of spontaneous intracranial hypotension (SIH) is caused by leakage of CSF from the thecal sac within or along the spinal canal.

• #64 Dedicated CSF Leak Program Created to Provide Expert Care for those with Spinal and Cranial CSF Leaks – Advances in Neurology | NewYork-Presbyterian

  https://www.nyp.org/advances/article/neurology-neurosurgery/dedicated-csf-leak-program-created-to-provide-expert-care-for-those-with-spinal-and-cranial-csf-leaks

  Cerebrospinal fluid (CSF) leaks are relatively rare but frequently misdiagnosed, due to the nonspecific symptoms with which patients may present. […] Because CSF leaks are relatively uncommon, they are not at the top of most physicians’ differential diagnosis lists. […] The initial evaluation of a patient with a suspected CSF leak includes a comprehensive medical evaluation often followed by brain and total spine MRI. […] The advanced diagnostic tools and procedures we offer are not available at many hospitals. They are the most important part of the diagnostic CSF leak workup and provide information that neuroradiologists and neurosurgeons can use to select the most targeted and effective treatments. […] Physicians are advised to make a referral for the evaluation and treatment of patients with a clear or suspected CSF leak. „It’s an uncommon but debilitating problem that should be part of the differential diagnosis for patients with this constellation of symptoms,” says Dr. Park.

• #65 Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study | European Journal of Human Genetics

  https://www.nature.com/articles/ejhg2012191

  We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. […] We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities. […] The prevalence of HDCT in patient with spontaneous CSF leaks has been rarely estimated. […] The recognition of HDCT in patients with spontaneous CSF leaks may be important mainly because of the potential vascular (and other connective tissue) fragility that is associated with them. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of HDCT, and that individuals with spontaneous CSF leaks should be evaluated for connective tissue and vascular abnormalities.

• #66 Cerebrospinal Fluid (CSF) Leak | Choose the Right Test

  https://arupconsult.com/content/csf-leak-beta-2-transferrin

  Spontaneous cerebrospinal fluid (CSF) leaks have been reported in association with heritable connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome. CSF leaks are thought to occur because of the fragility of connective tissue in these disorders. Some investigators suggest that all patients with spontaneous CSF leaks be evaluated for connective tissue and vascular anomalies. […] Unlike cranial cerebrospinal fluid (CSF) leaks, which can often be confirmed with laboratory testing, spinal CSF leaks are diagnosed with imaging. In patients with chronic, unresolved symptoms suggestive of intracranial hypotension without another overt cause, magnetic resonance imaging (MRI) or digital subtraction myelography can be used to confirm the existence and location of a spinal CSF leak.

• #67 Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study | European Journal of Human Genetics

  https://www.nature.com/articles/ejhg2012191

  We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. […] We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities. […] The prevalence of HDCT in patient with spontaneous CSF leaks has been rarely estimated. […] The recognition of HDCT in patients with spontaneous CSF leaks may be important mainly because of the potential vascular (and other connective tissue) fragility that is associated with them. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of HDCT, and that individuals with spontaneous CSF leaks should be evaluated for connective tissue and vascular abnormalities.

• #68 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25111523/

  Objective: To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. This condition is yet another public health problem related to the rising obesity epidemic.

• #69 Cerebrospinal Fluid Leaks: A Guide for the Comprehensive Otolaryngologist | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22923357/cerebrospinal-fluid-leaks-a-guide-for-the-comprehensive-otolaryngologist

  It is important to note that OSA raises CSF pressure due to high central venous pressures (high thoracic obstructive pressures), which transmit up to the dural venous sinuses, and which ultimately reduce CSF absorption via the arachnoid granulation system. […] In patients with the above risk factors, a high index of suspicion for CSF leak should be maintained and the provider should have a lower threshold to obtain further diagnostic workup. […] Beta-2 transferrin testing can confirm a leak, and imaging work-up with both CT and MRI is important to localize the leak and identify the underlying pathology. […] Classification into traumatic and nontraumatic leaks has important implications for prognosis and management.

• #70 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – University of Iowa

  https://iro.uiowa.edu/esploro/outputs/9984006484402771

  The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea. […] To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. […] This condition is yet another public health problem related to the rising obesity epidemic. […] All patients with spontaneous CSF leaks should be evaluated for OSA.

• #71 Cerebrospinal Fluid Leaks: A Guide for the Comprehensive Otolaryngologist | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22923357/cerebrospinal-fluid-leaks-a-guide-for-the-comprehensive-otolaryngologist

  CSF leaks can lead to serious complications if untreated, underscoring the need for prompt diagnosis, risk assessment, and appropriate management. […] Approximately 80%-90% of cranial CSF leaks are secondary to trauma. […] The incidence of leaks after accidental trauma ranges from 2% (all closed-head injuries) to 30% if a skull base fracture is present. […] Nontraumatic leaks, also referred to as spontaneous CSF leaks, comprise the other 10%-20% of cases. […] Most patients with spontaneous CSF leaks have an overweight or obese habitus as defined by having a body mass index (BMI) 25-30kg/m.2 Approximately 70% of non-traumatic leaks are associated with idiopathic intracranial hypertension (IIH) also known as pseudotumor cerebria condition in which ICP is elevated without clear underlying pathology.

• #72 Cerebrospinal Fluid Leaks: A Guide for the Comprehensive Otolaryngologist | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22923357/cerebrospinal-fluid-leaks-a-guide-for-the-comprehensive-otolaryngologist

  It is important to note that OSA raises CSF pressure due to high central venous pressures (high thoracic obstructive pressures), which transmit up to the dural venous sinuses, and which ultimately reduce CSF absorption via the arachnoid granulation system. […] In patients with the above risk factors, a high index of suspicion for CSF leak should be maintained and the provider should have a lower threshold to obtain further diagnostic workup. […] Beta-2 transferrin testing can confirm a leak, and imaging work-up with both CT and MRI is important to localize the leak and identify the underlying pathology. […] Classification into traumatic and nontraumatic leaks has important implications for prognosis and management.

• #73 Spinal CSF Leak | Duke Department of Radiology

  https://radiology.duke.edu/patient-care/specialized-services/spinal-csf-leak

  Duke is one of only three centers in the country that has been working continuously on this problem over the past fifteen years. […] Having treated thousands of people with suspected or confirmed cerebrospinal fluid leaks, patients travel to Duke from across the country and from Canada, Europe, the Far East, Africa, New Zealand, and Australia. […] Five Duke diagnostic and CT interventional neuroradiologists devote all of their time and energy to improving diagnosis and treatment for this debilitating disease. […] Specifically, we have developed innovative imaging techniques to detect and localize leaks, including ones that are difficult to detect by standard means; developed new treatments to seal leaks using minimally invasive procedures; and furthered the understanding of the long-term effects of CSF leaks and how to manage them.

• #74 Spinal CSF Leak | Duke Department of Radiology

  https://radiology.duke.edu/patient-care/specialized-services/spinal-csf-leak

  Duke is one of only three centers in the country that has been working continuously on this problem over the past fifteen years. […] Having treated thousands of people with suspected or confirmed cerebrospinal fluid leaks, patients travel to Duke from across the country and from Canada, Europe, the Far East, Africa, New Zealand, and Australia. […] Five Duke diagnostic and CT interventional neuroradiologists devote all of their time and energy to improving diagnosis and treatment for this debilitating disease. […] Specifically, we have developed innovative imaging techniques to detect and localize leaks, including ones that are difficult to detect by standard means; developed new treatments to seal leaks using minimally invasive procedures; and furthered the understanding of the long-term effects of CSF leaks and how to manage them.

• #75 Cerebrospinal fluid leak | Neurosurgery Inselspital Bern

  https://neurochirurgie.insel.ch/en/diseases-specialities/liquor-disorders/cerebrospinal-fluid-leak

  If the CSF leak does not close after bed rest and blood patch, or in cases of large fistulas with significant symptoms, the CSF fistula is closed surgically. […] A prerequisite for surgical treatment is the preceding exact localization of the fistula. Microsurgical treatment is then very successful. As a rule, the symptoms improve significantly immediately after the procedure or have disappeared completely. Treatment at the chronic stage is more difficult, but possible. […] Given the surgeon’s proven microsurgical experience on the spinal cord and special functional monitoring during the operation, the complication rate is very low. The success rate for sealing is high, nevertheless in about 6% of patients a second operation has to be performed to close the leak completely watertight. […] Inselspital is one of the three largest centers in Europe in the special field of cerebrospinal fluid leaks and has a great deal of experience.

• #76 Spinal Cerebrospinal Fluid (CSF) Leak of Canada

  https://www.spinalcsfleakcanada.ca/

  Spinal Cerebrospinal Fluid (CSF) Leak of Canada is a national health charity, with a mission to improve the lives of patients suffering from spontaneous intracranial hypotension (SIH) or spinal CSF leak. Our mission is achieved through advocacy and initiatives designed to raise awareness; through the education of patients and the Canadian medical community; and, through support for research to advance knowledge and combat this highly disabling neurological condition across the country. […] THE 2ND CANADIAN SIH CONFERENCE, HAS BEEN ACCREDITED FOR CONTINUING MEDICAL EDUCATION CREDIT.

• #77 Spinal CSF Leak | Duke Department of Radiology

  https://radiology.duke.edu/patient-care/specialized-services/spinal-csf-leak

  Duke is one of only three centers in the country that has been working continuously on this problem over the past fifteen years. […] Having treated thousands of people with suspected or confirmed cerebrospinal fluid leaks, patients travel to Duke from across the country and from Canada, Europe, the Far East, Africa, New Zealand, and Australia. […] Five Duke diagnostic and CT interventional neuroradiologists devote all of their time and energy to improving diagnosis and treatment for this debilitating disease. […] Specifically, we have developed innovative imaging techniques to detect and localize leaks, including ones that are difficult to detect by standard means; developed new treatments to seal leaks using minimally invasive procedures; and furthered the understanding of the long-term effects of CSF leaks and how to manage them.

• #78 Cerebrospinal Fluid Leak | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 49

  https://www.barrowneuro.org/condition/cerebrospinal-fluid-leak/

  A cerebrospinal fluid CSF leak, or CSF leak for short, is an escape of the colorless fluid that surrounds and protects the brain from the skull and spinal cord from the thecal sac (the tough covering surrounding the spinal cord) in the spine. […] CSF leaks are rare. They occur at a rate of approximately two to five cases for every 100,000 people, though this number is thought to be an underestimate. […] CSF leaks occur at a rate of approximately five cases for every 100,000 people, though this number is thought to be an underestimate.

• #79 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  A cerebrospinal fluid leak can affect many body systems, including balance, vision, hearing, brain function and more. […] Spontaneous CSF leaks are more likely in people over 30 (the average age to have them is 42). Females are also much more likely to develop spontaneous CSF leaks. […] Having a CSF leak causes a drop in fluid pressure inside your head. That causes a condition known as intracranial hypotension (intracranial means inside your skull and hypotension means lower than normal pressure). Intracranial hypotension is a rare condition, and about 5 people out of every 100,000 have it. […] However, it’s very likely that CSF leaks happen more often than that number suggests. Experts don’t know exactly how common CSF leaks are because they’re difficult to diagnose. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons.

• #80 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – University of Iowa

  https://iro.uiowa.edu/esploro/outputs/9984006484402771

  The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea. […] To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. […] This condition is yet another public health problem related to the rising obesity epidemic. […] All patients with spontaneous CSF leaks should be evaluated for OSA.

• #81 Cerebrospinal Fluid Leak | UCI Health | Orange County, CA

  https://www.ucihealth.org/medical-services/conditions/csf-leak

  Cerebrospinal fluid (CSF) is a colorless fluid that cushions the brain, protecting it from trauma and infections. […] Causes of CSF leak include head injuries and prior head or sinus surgery. […] This is a relatively rare condition with an average incidence of 0.001 percent (1:100000). […] Those most at risk are females between the ages of 20 and 45. Obesity is also a risk factor. […] The major risk of leaving a CSF leak unrepaired is a life-threatening infection of the lining of the brain called meningitis, which requires hospitalization and intravenous antibiotics to treat. […] A complete evaluation including a medical history and examination are first performed. […] A CT scan and/or MRI of the sinuses are often recommended to help identify the exact location of the defect responsible for the leak and assist with planning of the repair. […] The management of CSF leaks at UCI Health is a multidisciplinary approach between specialties. […] Once the leak is identified, it is repaired using the patients own tissue, which is usually obtained from the nose.

• #82 Cerebrospinal Fluid (CSF) Leak: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak

  CSF leak is not contagious. You cant give it to or get it from others. […] CSF leaks are sometimes tricky to diagnose, but the overall outlook for this condition is good. While the symptoms can be unpleasant, severe or disruptive, this condition is usually treatable. The overwhelming majority of people who have CSF leaks will either recover when the leak heals or with treatments or surgeries. […] Overall, the outlook for CSF leaks is very good. About 98% of people with CSF leaks will recover from them, no matter the cause.

• #83 Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study | European Journal of Human Genetics

  https://www.nature.com/articles/ejhg2012191

  We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. […] We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities. […] The prevalence of HDCT in patient with spontaneous CSF leaks has been rarely estimated. […] The recognition of HDCT in patients with spontaneous CSF leaks may be important mainly because of the potential vascular (and other connective tissue) fragility that is associated with them. […] We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of HDCT, and that individuals with spontaneous CSF leaks should be evaluated for connective tissue and vascular abnormalities.

• #84 The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea – University of Iowa

  https://iro.uiowa.edu/esploro/outputs/9984006484402771

  The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea. […] To determine the national rates of spontaneous CSF leaks and to determine the association with risk factors. […] The rate of craniotomy for spontaneous CSF leak repair has risen 2 fold from 2002 (218 cases per year) to 2012 (488 cases per year). […] The rate of spontaneous CSF leak repair is twice as high (2.54 versus 1.07 per million people per year) in regions of the United States with the highest obesity rate (Midwest) compared with the lowest obesity rate (West). […] The national rate of craniotomy for spontaneous CSF leak repair is rising. […] This condition is yet another public health problem related to the rising obesity epidemic. […] All patients with spontaneous CSF leaks should be evaluated for OSA.

• #85 What is a CSF Leak? | CSF Leak Association

  https://csfleak.uk/resource/what-is-a-csf-leak

  Spontaneous spinal CSF leaks, where the onset of symptoms comes out of the blue, were once considered rare, but are now known to be far more prevalent than first thought. Such leaks are increasingly attributed to an underlying congenital disorder, such as the Ehlers-Danlos Syndromes and other connective tissue diseases. […] While knowledge of CSF leaks may be limited within the general public and some sectors of the medical profession, such as general practice and emergency medicine, they are not uncommon and spontaneous CSF leaks affect at least 5 in 100,000 people every year.

Zobacz więcej