Materiały źródłowe

• #1 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. When there is a hole or tear in the outermost layer, a CSF leak occurs. The hole or tear in this outer layer, called the dura mater, allows some of the fluid to escape. […] There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. Each type has different symptoms, causes and treatments. […] Spinal CSF leaks may be caused by: A spinal tap, also called a lumbar puncture. An epidural in the spine for pain relief, such as during labor and delivery. An injury to the head or spine. Bone spurs along the spine. Irregularities of the dura mater around the nerve roots in the spine. Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. Prior surgery on the spine.

• #2 Cerebrospinal Fluid Leak | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cerebrospinal-fluid-leak.html

  Cerebrospinal fluid (CSF) leak occurs when there is a tear or hole in the membranes surrounding the brain or spinal cord, allowing the clear fluid that surrounds and cushions those organs to escape. […] Some CSF leaks occur spontaneously and the cause is unknown, while others are a result of trauma such as a head injury, brain or spinal surgery, an epidural, a lumbar puncture (spinal tap) or a skull base tumor. […] CSF leaks can be caused by an injury, surgery, an epidural, a spinal tap or a tumor.

• #3 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

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

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

  A cerebrospinal fluid leak (CSF) is when you’re leaking the fluid that surrounds your brain and spinal cord. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons. […] Many injuries can cause CSF leaks. These include: Injuries to your face, head, neck or spine. A common example of this is injuries from car crashes. […] In about 10% of cases, CSF leaks happen for unknown reasons. However, experts have connected this problem to a few other medical conditions. […] Connective tissue disorders that could cause a weakness in the layers of tissue that should contain the CSF (examples include Marfan syndrome and Ehlers-Danlos syndrome). […] Intracranial hypertension (high pressure inside your skull), which can cause tears in the surrounding tissue, creating a leak. […] Structural defects in how your nose, sinuses or other parts of your skull formed (either that you had when you were born or that developed or happened at some point in your life).

• #5 :: 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 early onset group includes the patients with CSF leak within 48 hours from trauma. […] The delayed onset group is defined as patients with CSF leak presented at least 1 week after trauma.

• #6 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. It occurs when there is a tear or hole in the dura mater, the meninges’ outermost layer that protects the central nervous system, communicating the subarachnoid space and other spaces via meningeal disruption. The most common cause of leaking cerebrospinal fluid is a structural compromise secondary to craniofacial trauma, making up 80% of CSF leaks. Iatrogenic causes comprise 16% of CSF leaks, with the last 4% due to varied etiologies. CSF leak is typically classified into spontaneous/idiopathic, traumatic, and iatrogenic. […] Craniofacial trauma can lead to varied presentations of CSF leak, determined primarily by injury location and mechanism of action. Skull base CSF leaks occur when there is an abnormal communication between the subarachnoid space and air space in the paranasal sinuses, nasal cavity, middle ear, or mastoid cells. Anterior skull base fractures are frequently associated with moderate-to-high-velocity impact.

• #7 Cerebrospinal fluid (CSF) leak: Symptoms, treatment, and more

  https://www.medicalnewstoday.com/articles/327363

  A CSF leak occurs when cerebrospinal fluid (CSF) escapes from the protective layer surrounding the brain and spinal cord. […] The most common cause of CSF leaks is head trauma. Blunt force head injuries can fracture bones in the face or the temporal bones on either side of the skull. These fractures can also tear the dura mater, the outermost layer of the meninges, causing a CSF leak. […] Other causes of a CSF leak in the skull or spine include infection, an epidural injection, an anesthetic injection, intracranial hypertension, venous fistula, a lumbar puncture, brain tumors, surgery on or around the base of the skull or spine, and structural abnormalities of the skull that have been present from birth. […] A CSF leak is a serious issue that can cause complications such as headaches, meningitis, and seizures. […] The symptoms of a CSF leak include fluid drainage from the ears or nose and a headache that worsens when the head is upright. […] These leaks can result from head injuries, infections, and certain medical procedures.

• #8 Understanding CSF Leaks: Causes, Symptoms, and Risks – Dr. Amy Anstead

  https://pugetsoundsinus.com/news/understanding-csf-leaks-causes-symptoms-and-risks/

  Understanding a CSF Leak […] The majority of CSF leak causes are a result of injuries, but some occur spontaneously for unknown reasons. […] Some injuries that result in CSF leaks include: penetrating injuries, such as stab wounds or punctures; injuries to the face, head, neck, or spine; injuries from brain surgery; injuries from ear, nose, and throat medical procedures; injuries from medical procedures that take place around the spine, such as a spinal tap or epidural. […] Spontaneous CSF leaks have no known direct cause, but medical researchers have identified a few medical conditions that tend to be present in those who have a spontaneous CSF leak: obesity, classes 2 and 3 especially; structural defects in how the nose, sinuses, and other parts of the skull have formed; connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome; intracranial hypertension (high pressure within the skull).

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

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

  A cerebrospinal fluid leak (CSF) is when you’re leaking the fluid that surrounds your brain and spinal cord. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons. […] Many injuries can cause CSF leaks. These include: Injuries to your face, head, neck or spine. A common example of this is injuries from car crashes. […] In about 10% of cases, CSF leaks happen for unknown reasons. However, experts have connected this problem to a few other medical conditions. […] Connective tissue disorders that could cause a weakness in the layers of tissue that should contain the CSF (examples include Marfan syndrome and Ehlers-Danlos syndrome). […] Intracranial hypertension (high pressure inside your skull), which can cause tears in the surrounding tissue, creating a leak. […] Structural defects in how your nose, sinuses or other parts of your skull formed (either that you had when you were born or that developed or happened at some point in your life).

• #10 Cerebrospinal Fluid Leak | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cerebrospinal-fluid-leak.html

  Cerebrospinal fluid (CSF) leak occurs when there is a tear or hole in the membranes surrounding the brain or spinal cord, allowing the clear fluid that surrounds and cushions those organs to escape. […] Some CSF leaks occur spontaneously and the cause is unknown, while others are a result of trauma such as a head injury, brain or spinal surgery, an epidural, a lumbar puncture (spinal tap) or a skull base tumor. […] CSF leaks can be caused by an injury, surgery, an epidural, a spinal tap or a tumor.

• #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. It occurs when there is a tear or hole in the dura mater, the meninges’ outermost layer that protects the central nervous system, communicating the subarachnoid space and other spaces via meningeal disruption. The most common cause of leaking cerebrospinal fluid is a structural compromise secondary to craniofacial trauma, making up 80% of CSF leaks. Iatrogenic causes comprise 16% of CSF leaks, with the last 4% due to varied etiologies. CSF leak is typically classified into spontaneous/idiopathic, traumatic, and iatrogenic. […] Craniofacial trauma can lead to varied presentations of CSF leak, determined primarily by injury location and mechanism of action. Skull base CSF leaks occur when there is an abnormal communication between the subarachnoid space and air space in the paranasal sinuses, nasal cavity, middle ear, or mastoid cells. Anterior skull base fractures are frequently associated with moderate-to-high-velocity impact.

• #12 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

• #13 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

• #14 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

• #15 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

• #16 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  There are several known causes of intracranial hypotension (low volume of cerebrospinal fluid in the head) due to spinal CSF leak. […] The most common cause of a spinal CSF leak is lumbar puncture, and the headache caused by a spinal CSF leak due to lumbar puncture is referred to as a PostDural Puncture Headache (PDPH). […] Dural tears may occur inadvertently at the time of epidural injections. […] They may occur at the time of spinal or other surgery. […] CSF shunt over-drainage may also cause intracranial hypotension. […] Chiropractic or other spinal manipulation has been reported as another cause of spinal CSF leak. […] Traumatic leaks have been reported in association with brachial plexus injuries, spinal injuries, sports injuries, and falls. […] Spontaneous leaks appear seemingly out of nowhere.

• #17 Spinal Fluid Leak: Causes, Symptoms, Treatment, and Outlook

  https://www.healthline.com/health/spinal-fluid-leak

  Common symptoms of a spinal fluid leak are head pain, nausea, and neck stiffness. […] A spinal fluid leak can occur when the fluid surrounding the brain and spinal cord leaks out through a hole in the surrounding connective tissues. This can occur as a result of an injury, lumbar puncture, or an epidural. Sometimes, there is no known cause. […] Anyone is at risk for a CSF leak. These leaks can be caused by: a head injury, head, brain, or spinal surgeries, a spinal tap (lumbar puncture), tube placement for an epidural. […] If the connective tissues or dura mater are weak, this can predispose a person to CSF leaks. […] People with connective tissue diseases may also be at higher risk of CSF leaks. Connective tissue diseases may be genetic or related to autoimmune disorders. […] Sometimes, the cause cannot be found. This is otherwise referred to as a spontaneous CSF leak. […] The most common cause is due to a lumbar puncture. Sometimes, chiropractic manipulation can cause CSF leaks.

• #18 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. When there is a hole or tear in the outermost layer, a CSF leak occurs. The hole or tear in this outer layer, called the dura mater, allows some of the fluid to escape. […] There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. Each type has different symptoms, causes and treatments. […] Spinal CSF leaks may be caused by: A spinal tap, also called a lumbar puncture. An epidural in the spine for pain relief, such as during labor and delivery. An injury to the head or spine. Bone spurs along the spine. Irregularities of the dura mater around the nerve roots in the spine. Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. Prior surgery on the spine.

• #19 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. When there is a hole or tear in the outermost layer, a CSF leak occurs. The hole or tear in this outer layer, called the dura mater, allows some of the fluid to escape. […] There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. Each type has different symptoms, causes and treatments. […] Spinal CSF leaks may be caused by: A spinal tap, also called a lumbar puncture. An epidural in the spine for pain relief, such as during labor and delivery. An injury to the head or spine. Bone spurs along the spine. Irregularities of the dura mater around the nerve roots in the spine. Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. Prior surgery on the spine.

• #20 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. […] The subject of CSF otorrhea covers a broad range of potential pathologies. Most of such leaks are postoperative and are a recognized complication of acoustic neuroma surgery. Some occur as a result of middle ear surgery or erosive disease, such as cholesteatoma, sometimes many years later. Some may be the result of congenital abnormalities in the formation of the inner ear and the mastoid. […] The underlying etiology of a spinal fluid leak through the temporal bone is a violation of the bony and meningeal barriers that separate the subarachnoid space from the middle ear and mastoid. This means that a defect must exist not only in the bone, but also in the dura mater. Such problems may be postsurgical, posttraumatic, congenital, or related to otologic disease.

• #21 CSF leak: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001068.htm

  A CSF leak is an escape of the fluid that surrounds the brain and spinal cord. This fluid is called the cerebrospinal fluid (CSF). […] Any tear or hole in the membrane that surrounds the brain and spinal cord (dura) can allow the fluid that surrounds those organs to leak. When it leaks out, the pressure around the brain and spinal cord drops. […] Causes of leakage through the dura include: Certain head, brain, or spinal surgeries, Head or spine injury, Placement of tubes for epidural anesthesia or pain medicines, Spinal tap (lumbar puncture). […] Sometimes, no cause can be found. This is called a spontaneous CSF leak. […] Most CSF leaks are a complication of a spinal tap or surgery. The provider should use the smallest needle possible when doing a spinal tap.

• #22 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  There are several known causes of intracranial hypotension (low volume of cerebrospinal fluid in the head) due to spinal CSF leak. […] The most common cause of a spinal CSF leak is lumbar puncture, and the headache caused by a spinal CSF leak due to lumbar puncture is referred to as a PostDural Puncture Headache (PDPH). […] Dural tears may occur inadvertently at the time of epidural injections. […] They may occur at the time of spinal or other surgery. […] CSF shunt over-drainage may also cause intracranial hypotension. […] Chiropractic or other spinal manipulation has been reported as another cause of spinal CSF leak. […] Traumatic leaks have been reported in association with brachial plexus injuries, spinal injuries, sports injuries, and falls. […] Spontaneous leaks appear seemingly out of nowhere.

• #23 Spinal Fluid Leak: Causes, Symptoms, Treatment, and Outlook

  https://www.healthline.com/health/spinal-fluid-leak

  Common symptoms of a spinal fluid leak are head pain, nausea, and neck stiffness. […] A spinal fluid leak can occur when the fluid surrounding the brain and spinal cord leaks out through a hole in the surrounding connective tissues. This can occur as a result of an injury, lumbar puncture, or an epidural. Sometimes, there is no known cause. […] Anyone is at risk for a CSF leak. These leaks can be caused by: a head injury, head, brain, or spinal surgeries, a spinal tap (lumbar puncture), tube placement for an epidural. […] If the connective tissues or dura mater are weak, this can predispose a person to CSF leaks. […] People with connective tissue diseases may also be at higher risk of CSF leaks. Connective tissue diseases may be genetic or related to autoimmune disorders. […] Sometimes, the cause cannot be found. This is otherwise referred to as a spontaneous CSF leak. […] The most common cause is due to a lumbar puncture. Sometimes, chiropractic manipulation can cause CSF leaks.

• #24 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

• #25 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  There are several known causes of intracranial hypotension (low volume of cerebrospinal fluid in the head) due to spinal CSF leak. […] The most common cause of a spinal CSF leak is lumbar puncture, and the headache caused by a spinal CSF leak due to lumbar puncture is referred to as a PostDural Puncture Headache (PDPH). […] Dural tears may occur inadvertently at the time of epidural injections. […] They may occur at the time of spinal or other surgery. […] CSF shunt over-drainage may also cause intracranial hypotension. […] Chiropractic or other spinal manipulation has been reported as another cause of spinal CSF leak. […] Traumatic leaks have been reported in association with brachial plexus injuries, spinal injuries, sports injuries, and falls. […] Spontaneous leaks appear seemingly out of nowhere.

• #26 CSF Leaks in Hydrocephalus: Causes, Symptoms & Treatment

  https://www.hydroassoc.org/csf-leaks-in-hydrocephalus/

  Surgical Interventions: Procedures like endoscopic third ventriculostomy (ETV) or shunt placement can sometimes create small tears in the dura. Spinal surgery can also result in tears to the dura. […] Trauma: Head injuries or falls can compromise the integrity of the dura, leading to a leak. This is particularly common if there is a fracture of the bones forming the base of the skull. […] Overdrainage: Excessive drainage of CSF from a shunt can create pressure imbalances that act just like a CSF leak. […] Medical Procedures: Lumbar punctures or epidural injections can also inadvertently cause a CSF leak. The lumbar puncture does penetrate the dura, and after the needle is withdrawn the hole may not seal right away. An epidural injection may accidentally penetrate the dura. […] Risk Factors: Factors such as high body mass index (BMI), advanced age, or pre-existing connective tissue disorders may also increase susceptibility to CSF leaks.

• #27 Cerebrospinal Fluid Leak – StatPearls – NCBI Bookshelf

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

  Iatrogenic CSF leaks occur most frequently as sequelae to functional endoscopic sinus surgery. The cribriform plate and ethmoid bone are the most commonly injured, followed by the frontal and sphenoid sinuses. Neurosurgical interventions contribute to iatrogenic leaks, especially with the increased prevalence of endoscopic transnasal pituitary surgeries. […] Spontaneous CSF leaks occur without an obvious inciting event, often at the spine level, only rarely from the skull base. Spontaneous leaks are typically attributed to underlying conditions resulting in decreased intracranial pressure (ICP), leading to orthostatic headaches, the most common clinical manifestation. […] According to Ommaya et al., 80 % of CSF leak is due to nonsurgical trauma, 16 % is iatrogenic, and 4 % is spontaneous. […] The most serious potential complication of CSF leak is meningitis. This risk appears to be highest in the preoperative period for those with confirmed CSF rhinorrhea, with those sustaining traumatic injuries having the highest risk of around 30%.

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

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

  A cerebrospinal fluid leak (CSF) is when you’re leaking the fluid that surrounds your brain and spinal cord. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons. […] Many injuries can cause CSF leaks. These include: Injuries to your face, head, neck or spine. A common example of this is injuries from car crashes. […] In about 10% of cases, CSF leaks happen for unknown reasons. However, experts have connected this problem to a few other medical conditions. […] Connective tissue disorders that could cause a weakness in the layers of tissue that should contain the CSF (examples include Marfan syndrome and Ehlers-Danlos syndrome). […] Intracranial hypertension (high pressure inside your skull), which can cause tears in the surrounding tissue, creating a leak. […] Structural defects in how your nose, sinuses or other parts of your skull formed (either that you had when you were born or that developed or happened at some point in your life).

• #29 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

• #30 Cerebrospinal fluid leak – MEpedia

  https://me-pedia.org/wiki/Cerebrospinal_fluid_leak

  A cerebrospinal fluid leak or cerebral spinal fluid leak occurs when a tear or hole happens in the dura mater, the outermost membrane enveloping the brain and spinal cord. […] Leaks can occur after lumbar punctures, epidurals, and surgery. […] They can also happen spontaneously. […] Risk factors for spontaneous (idiopathic) leaks as well as leaks following procedures include connective tissue disorders such as Ehlers-Danlos syndrome. […] Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] There is a growing evidence base suggesting that a significant proportion of spontaneous spinal CSF leaks occur as a result of preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in affected individuals; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are uncommon, but not rare. One estimate of annual incidence is 5 in 100,000, however this has not been well-studied.

• #31 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. Nasal CSF leaks are caused by small, sometimes microscopic breaks in the barrier between the brain and roof of the sinuses. […] Causes of CSF leak include head injuries and prior head or sinus surgery. […] Some leaks occur spontaneously without any trauma in patients with elevated intracranial pressure, termed idiopathic intracranial hypertension (IIH). […] Those most at risk are females between the ages of 20 and 45. Obesity is also a risk factor.

• #32 CSF Rhinorrhea: Practice Essentials, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/861126-overview

  A literature review by Lobo et al indicated that in addition to increased ICP, risk factors for spontaneous CSF leaks include obesity, female gender, and obstructive sleep apnea. […] Penetrating and closed-head trauma are responsible for 90% of all cases of CSF leaks. […] Any surgical manipulation near the skull base can result in an iatrogenic CSF leak. […] The growth of benign tumors does not commonly result in CSF rhinorrhea. However, locally aggressive lesions such as inverted papilloma and malignant neoplasms can erode the bone of the anterior cranial fossa. […] Defects in the closure of the anterior neuropore can cause herniation of central nervous tissue through the anterior cranial fossa. […] Spontaneous CSF rhinorrhea occurs in patients without antecedent causes. This terminology seems to imply that spontaneous CSF leaks are idiopathic in nature; however, evidence has led to the realization that spontaneous CSF rhinorrhea may in reality be secondary to an intracranial process, namely elevated intracranial pressure (ICP). […] Despite the multifactorial causes of elevated ICP, once this problem ensues, the pressure exerted on areas of the anterior skull base such as the lateral lamella of the cribriform or lateral recess of the sphenoid sinus results in bone remodeling and thinning. Ultimately, a defect is formed.

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

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

  A cerebrospinal fluid leak (CSF) is when you’re leaking the fluid that surrounds your brain and spinal cord. […] Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons. […] Many injuries can cause CSF leaks. These include: Injuries to your face, head, neck or spine. A common example of this is injuries from car crashes. […] In about 10% of cases, CSF leaks happen for unknown reasons. However, experts have connected this problem to a few other medical conditions. […] Connective tissue disorders that could cause a weakness in the layers of tissue that should contain the CSF (examples include Marfan syndrome and Ehlers-Danlos syndrome). […] Intracranial hypertension (high pressure inside your skull), which can cause tears in the surrounding tissue, creating a leak. […] Structural defects in how your nose, sinuses or other parts of your skull formed (either that you had when you were born or that developed or happened at some point in your life).

• #34 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

• #35 Cerebrospinal Fluid Leaks (CSF Leaks) in EDS and Hypermobility Syndromes | The EDS Clinic

  https://www.eds.clinic/articles/cerebrospinal-fluid-csf-leaks-in-eds-and-hypermobility-syndromes

  Cerebrospinal fluid surrounds and protects the brain and spinal cord, maintaining stable pressure and acting as a cushion against injury. When there is a breach in the dura mater, CSF can leak out, causing a drop in intracranial pressure, which leads to a range of symptoms, particularly positional headaches that worsen when upright and improve when lying down. […] Spontaneous CSF leaks occur without any apparent trauma or injury, and they are often linked to underlying conditions that weaken connective tissues, such as Ehlers-Danlos Syndrome (EDS) or Marfan syndrome. These leaks are usually the result of structural weaknesses in the dura mater, making the membrane more prone to tears. […] Individuals with Ehlers-Danlos Syndrome (EDS), particularly the hypermobile type (hEDS), are at higher risk for spontaneous CSF leaks due to their connective tissue abnormalities. The collagen defects in EDS result in weakened dura mater, which is more prone to spontaneous tears, leading to CSF leaks.

• #36

  https://journals.lww.com/sjoh/fulltext/2021/23030/pathophysiology_of_skull_base_defects_and.1.aspx

  The exact cause of IIH is still unknown. However, some mechanisms have been hypothesized about the impaired hydrodynamics of CSF. Researchers believe that cerebral venous hypertension and altered venous outflow are the main mechanisms in the development of IIH. […] There is a well-recognized association between body mass index (BMI) and IIH. More than 70% of IIH patients are obese, and weight loss is well known to improve symptoms of elevated ICP and CSF opening pressures. […] OSA is more prevalent in patients with spontaneous CSF leak in comparison to other CSF leak patients and the general population. […] The lateral recess of the sphenoid sinus and the cribriform plate of the ethmoid bone are the most common sites of meningoceles and spontaneous CSF leaks. […] Congenital meningoencephalocele may present as an intranasal/extranasal mass.

• #37 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. Nasal CSF leaks are caused by small, sometimes microscopic breaks in the barrier between the brain and roof of the sinuses. […] Causes of CSF leak include head injuries and prior head or sinus surgery. […] Some leaks occur spontaneously without any trauma in patients with elevated intracranial pressure, termed idiopathic intracranial hypertension (IIH). […] Those most at risk are females between the ages of 20 and 45. Obesity is also a risk factor.

• #38

  https://journals.lww.com/sjoh/fulltext/2021/23030/pathophysiology_of_skull_base_defects_and.1.aspx

  The exact cause of IIH is still unknown. However, some mechanisms have been hypothesized about the impaired hydrodynamics of CSF. Researchers believe that cerebral venous hypertension and altered venous outflow are the main mechanisms in the development of IIH. […] There is a well-recognized association between body mass index (BMI) and IIH. More than 70% of IIH patients are obese, and weight loss is well known to improve symptoms of elevated ICP and CSF opening pressures. […] OSA is more prevalent in patients with spontaneous CSF leak in comparison to other CSF leak patients and the general population. […] The lateral recess of the sphenoid sinus and the cribriform plate of the ethmoid bone are the most common sites of meningoceles and spontaneous CSF leaks. […] Congenital meningoencephalocele may present as an intranasal/extranasal mass.

• #39 Expert Treatment for Cerebrospinal Fluid Leaks | Skull Base Conditions | Ear, Nose and Throat Services | University Hospitals | Cleveland, OH | University Hospitals

  https://www.uhhospitals.org/services/ear-nose-and-throat-services/conditions-and-treatments/skull-base-conditions/cerebrospinal-fluid-leaks

  Cerebrospinal fluid (CSF) or brain fluid is a clear liquid that surrounds and cushions the brain. A break or defect in the dura can allow CSF to leak into the nose and sinuses or into the ear. There are many causes of CSF leaks including spontaneous (mechanism not completely understood), traumatic injury, or as the result of surgery in and around the brain. […] Weakening of the bone that can lead to encephalocele can be congenital (present at birth) or may develop slowly over time as a person ages. It can also be the result of chronic ear infections and/or prior ear surgery performed to treat ear infections or other conditions. Obesity and obstructive sleep apnea are also potential risk factors for CSF leaks due to encephalocele.

• #40 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

• #41 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

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

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

  Cerebrospinal fluid (CSF) is a type of clear liquid that surrounds, protects, and cushions your brain and spinal cord from possible injuries. A CSF leak may occur if there’s a tear or a hole in the dura mater. There are two types of CSF leaks. If the fluid leaks from the brain such as with a skull fracture, it’s called a cranial CSF leak. If the leak occurs at any point along the spinal cord, it’s called a spinal CSF leak. […] In some cases, there’s no known cause for a leak. Doctors call this a spontaneous CSF leak. But there are known causes for the fluid to leak out, such as: lumbar puncture called a spinal tap, history of epidurals, spinal catheters, trauma or injuries to your head, neck or spine, spinal surgeries, epidural shot, transsphenoidal surgery, defects in the skull base, such as meningoencephaloceles, abnormal CSF buildup in the brain, which increases the pressure, untreated intracranial hypertension (high brain fluid pressure), connective tissue diseases such as Ehlers-Danlos and Marfan syndromes, bone spurs in the spine.

• #43 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. Nasal CSF leaks are caused by small, sometimes microscopic breaks in the barrier between the brain and roof of the sinuses. […] Causes of CSF leak include head injuries and prior head or sinus surgery. […] Some leaks occur spontaneously without any trauma in patients with elevated intracranial pressure, termed idiopathic intracranial hypertension (IIH). […] Those most at risk are females between the ages of 20 and 45. Obesity is also a risk factor.

• #44 CSF Rhinorrhea: Practice Essentials, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/861126-overview

  A literature review by Lobo et al indicated that in addition to increased ICP, risk factors for spontaneous CSF leaks include obesity, female gender, and obstructive sleep apnea. […] Penetrating and closed-head trauma are responsible for 90% of all cases of CSF leaks. […] Any surgical manipulation near the skull base can result in an iatrogenic CSF leak. […] The growth of benign tumors does not commonly result in CSF rhinorrhea. However, locally aggressive lesions such as inverted papilloma and malignant neoplasms can erode the bone of the anterior cranial fossa. […] Defects in the closure of the anterior neuropore can cause herniation of central nervous tissue through the anterior cranial fossa. […] Spontaneous CSF rhinorrhea occurs in patients without antecedent causes. This terminology seems to imply that spontaneous CSF leaks are idiopathic in nature; however, evidence has led to the realization that spontaneous CSF rhinorrhea may in reality be secondary to an intracranial process, namely elevated intracranial pressure (ICP). […] Despite the multifactorial causes of elevated ICP, once this problem ensues, the pressure exerted on areas of the anterior skull base such as the lateral lamella of the cribriform or lateral recess of the sphenoid sinus results in bone remodeling and thinning. Ultimately, a defect is formed.

• #45

  https://journals.lww.com/sjoh/fulltext/2021/23030/pathophysiology_of_skull_base_defects_and.1.aspx

  In the current practice, rhinology is the most litigated subspecialty of otolaryngology, and the most common litigated rhinology procedure is functional endoscopic sinus surgery. […] Dural tears and CSF leaks occur in 10%30% of skull base fractures because the dura is extremely adherent to the skull base. […] CSF leak is a rare pathology with many etiologies. It can be spontaneous, congenital, iatrogenic, or traumatic. A skull base defect may occur along the anterior or lateral skull base manifesting as CSF rhinorrhea or CSF otorrhea, and multiple defects could happen simultaneously in the same patient.

• #46 Cerebrospinal fluid leak – Wikipedia

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

  Various scientists and physicians have suggested that sCSFLs may be the result of an underlying connective tissue disorder affecting the spinal dura. It may also run in families and be associated with aortic aneurysms and joint hypermobility. Up to two thirds of those affected demonstrate some type of generalized connective tissue disorder. Marfan syndrome, EhlersDanlos syndrome, and autosomal dominant polycystic kidney disease are the three most common connective tissue disorders associated with sCSFLs. […] Cranial CSF leaks result from intracranial hypertension in the vast majority of cases. The increased pressure causes a rupture of the cranial dura mater, leading to a CSF leak and intracranial hypotension. Patients with a nude nerve root, where the root sleeve is absent, are at increased risk for developing recurrent CSF leaks. Lumbar disc herniation has been reported to cause CSF leaks in at least one case. […] CSF leaks can result from a lumbar puncture procedure.

• #47 Spinal CSF leak – Causes – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/about-spinal-csf-leaks/causes-of-spinal-csf-leak/

  Spontaneous spinal CSF leaks may be associated with spinal pathology such as calcified disc material or bone spurs. […] Spontaneous leaks may also be associated with preexisting weakness of the dura mater. […] Heritable Disorders of Connective Tissue (HDCT) occur at a higher frequency in people affected by spinal CSF leak; intracranial hypotension may be the first noted manifestation. […] Spontaneous leaks may also be caused by CSF-venous fistula, an abnormal connection between the normal space containing CSF and veins outside the dura mater. […] Spontaneous spinal CSF leaks are uncommon, but not rare. […] The use of pencil-point LP needles reduces the risk of postdural puncture headache. […] Spontaneous spinal CSF leaks are recognized less readily than iatrogenic spinal CSF leaks. […] Spontaneous spinal CSF leaks are often associated with an underlying Heritable Disorder of Connective Tissue; intracranial hypotension may be the first noted manifestation. […] Spontaneous spinal CSF leaks are also associated with pre-existing spinal pathology.

• #48 Cerebrospinal Fluid Leaks (CSF Leaks) in EDS and Hypermobility Syndromes | The EDS Clinic

  https://www.eds.clinic/articles/cerebrospinal-fluid-csf-leaks-in-eds-and-hypermobility-syndromes

  Cerebrospinal fluid surrounds and protects the brain and spinal cord, maintaining stable pressure and acting as a cushion against injury. When there is a breach in the dura mater, CSF can leak out, causing a drop in intracranial pressure, which leads to a range of symptoms, particularly positional headaches that worsen when upright and improve when lying down. […] Spontaneous CSF leaks occur without any apparent trauma or injury, and they are often linked to underlying conditions that weaken connective tissues, such as Ehlers-Danlos Syndrome (EDS) or Marfan syndrome. These leaks are usually the result of structural weaknesses in the dura mater, making the membrane more prone to tears. […] Individuals with Ehlers-Danlos Syndrome (EDS), particularly the hypermobile type (hEDS), are at higher risk for spontaneous CSF leaks due to their connective tissue abnormalities. The collagen defects in EDS result in weakened dura mater, which is more prone to spontaneous tears, leading to CSF leaks.

• #49 Cerebrospinal Fluid Leaks (CSF Leaks) in EDS and Hypermobility Syndromes | The EDS Clinic

  https://www.eds.clinic/articles/cerebrospinal-fluid-csf-leaks-in-eds-and-hypermobility-syndromes

  Several factors contribute to spontaneous CSF leaks, with connective tissue disorders like Ehlers-Danlos syndrome being a significant underlying cause. […] People with conditions like Ehlers-Danlos Syndrome (EDS) and Marfan syndrome often experience weakened connective tissues, including the dura mater. This makes the dura more susceptible to spontaneous tears and leaks. Research highlights that collagen abnormalities in these patients can lead to weakened dura mater, making spontaneous leaks more likely. […] CSF leaks can result from spontaneous causes, trauma, or medical procedures and can significantly impact quality of life. Proper diagnosis and treatment are critical to managing symptoms and preventing long-term neurological damage. For individuals with connective tissue disorders like Ehlers-Danlos Syndrome, addressing the underlying collagen defect is key to reducing the risk of recurrent leaks.

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

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

  A cerebrospinal fluid (CSF) leak occurs when fluid seeps out of the brain and spinal cord region from a tear in the outer layer closest to the skull. […] There are several causes of cranial and spinal CSF leaks, which may be brought on by nonsurgical trauma, surgical trauma, or even spontaneously. […] A cranial CSF leak may be caused by: Head trauma or injury, Tumors, Certain surgical procedures, Infection, Intracranial hypertension/head pressure. […] Causes of spinal CSF leaks include: Lumber pressure/spinal tap, Congenital birth defects, Epidural anesthesia, Head/spine injury, Certain dura matter and nerve abnormalities, Bone spurs/calcified disc herniations. […] Some cranial and spine CSF leaks may not have an identifiable cause.

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

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

  Cranial CSF leaks may be caused by: A head injury. Sinus surgery. Increased pressure in the brain. Malformations of the inner ear. […] Sometimes CSF leaks develop after very minor events: Sneezing. Coughing. Straining to have a bowel movement. Lifting heavy objects. Falling. Stretching. Exercise. […] When there is no surgery or procedure prior to the start of a CSF leak, it is called a spontaneous CSF leak.

• #52

  https://journals.lww.com/sjoh/fulltext/2021/23030/pathophysiology_of_skull_base_defects_and.1.aspx

  The exact cause of IIH is still unknown. However, some mechanisms have been hypothesized about the impaired hydrodynamics of CSF. Researchers believe that cerebral venous hypertension and altered venous outflow are the main mechanisms in the development of IIH. […] There is a well-recognized association between body mass index (BMI) and IIH. More than 70% of IIH patients are obese, and weight loss is well known to improve symptoms of elevated ICP and CSF opening pressures. […] OSA is more prevalent in patients with spontaneous CSF leak in comparison to other CSF leak patients and the general population. […] The lateral recess of the sphenoid sinus and the cribriform plate of the ethmoid bone are the most common sites of meningoceles and spontaneous CSF leaks. […] Congenital meningoencephalocele may present as an intranasal/extranasal mass.

• #53 CSF Rhinorrhea: Practice Essentials, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/861126-overview

  A literature review by Lobo et al indicated that in addition to increased ICP, risk factors for spontaneous CSF leaks include obesity, female gender, and obstructive sleep apnea. […] Penetrating and closed-head trauma are responsible for 90% of all cases of CSF leaks. […] Any surgical manipulation near the skull base can result in an iatrogenic CSF leak. […] The growth of benign tumors does not commonly result in CSF rhinorrhea. However, locally aggressive lesions such as inverted papilloma and malignant neoplasms can erode the bone of the anterior cranial fossa. […] Defects in the closure of the anterior neuropore can cause herniation of central nervous tissue through the anterior cranial fossa. […] Spontaneous CSF rhinorrhea occurs in patients without antecedent causes. This terminology seems to imply that spontaneous CSF leaks are idiopathic in nature; however, evidence has led to the realization that spontaneous CSF rhinorrhea may in reality be secondary to an intracranial process, namely elevated intracranial pressure (ICP). […] Despite the multifactorial causes of elevated ICP, once this problem ensues, the pressure exerted on areas of the anterior skull base such as the lateral lamella of the cribriform or lateral recess of the sphenoid sinus results in bone remodeling and thinning. Ultimately, a defect is formed.

• #54 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. When there is a hole or tear in the outermost layer, a CSF leak occurs. The hole or tear in this outer layer, called the dura mater, allows some of the fluid to escape. […] There are two distinct types of CSF leaks: spinal CSF leaks and cranial CSF leaks. Each type has different symptoms, causes and treatments. […] Spinal CSF leaks may be caused by: A spinal tap, also called a lumbar puncture. An epidural in the spine for pain relief, such as during labor and delivery. An injury to the head or spine. Bone spurs along the spine. Irregularities of the dura mater around the nerve roots in the spine. Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. Prior surgery on the spine.

• #55 CSF leak (Cerebrospinal fluid leak) – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/csf-leak-cerebrospinal-fluid-leak/

  Cerebrospinal fluid (CSF) surrounds your brain and spinal cord and provides a cushion to protect them from injury. A CSF leak occurs when there is a hole or tear in the outermost layer of these membranes (dura mater), which allows some of the fluid to escape. […] There are two distinct types of CSF leaks with different symptoms, causes and treatments. These are 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. […] Spinal CSF leaks may be caused by: A lumbar puncture (spinal tap), An epidural in the spine for pain relief, such as during labor and delivery, An injury to the head or spine, Bone spurs along the spine, Abnormalities of the dura mater around the nerve roots in the spine, Abnormal connections between dura mater and veins (CSF-venous fistulas), Prior surgery on the spine. […] Cranial CSF leaks may be caused by: A head injury, Increased pressure in the brain, Poorly functioning shunt, Malformations of the inner ear. […] Sometimes a CSF leak doesn’t have a known cause (spontaneous CSF leak).

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

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

  Cranial leaks may occur in the nose following surgery (rhinorrhea), from the external auditory canal (otorrhea) or from an operative defect in the skull. […] Spinal CSF leaks, particularly those resulting from trauma or occurring spontaneously, are commonly found at the thoracic spine and cervicothoracic junction. […] 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. […] CSF- Venus Fistulas can be treated by a variety of interventions including embolisation of the affected area.

• #57 Cerebrospinal fluid leak – Wikipedia

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

  Various scientists and physicians have suggested that sCSFLs may be the result of an underlying connective tissue disorder affecting the spinal dura. It may also run in families and be associated with aortic aneurysms and joint hypermobility. Up to two thirds of those affected demonstrate some type of generalized connective tissue disorder. Marfan syndrome, EhlersDanlos syndrome, and autosomal dominant polycystic kidney disease are the three most common connective tissue disorders associated with sCSFLs. […] Cranial CSF leaks result from intracranial hypertension in the vast majority of cases. The increased pressure causes a rupture of the cranial dura mater, leading to a CSF leak and intracranial hypotension. Patients with a nude nerve root, where the root sleeve is absent, are at increased risk for developing recurrent CSF leaks. Lumbar disc herniation has been reported to cause CSF leaks in at least one case. […] CSF leaks can result from a lumbar puncture procedure.

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

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

  Cranial CSF leaks may be caused by: A head injury. Sinus surgery. Increased pressure in the brain. Malformations of the inner ear. […] Sometimes CSF leaks develop after very minor events: Sneezing. Coughing. Straining to have a bowel movement. Lifting heavy objects. Falling. Stretching. Exercise. […] When there is no surgery or procedure prior to the start of a CSF leak, it is called a spontaneous CSF leak.

• #59 CSF Leak (Cerebrospinal Fluid Leak): Causes, Symptoms and Treatment | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/csf-leak-cerebrospinal-fluid-leak-causes-symptoms-and-treatment

  Cranial CSF leaks may be caused by: An injury to the head, An increase in brain pressure, Shunts that do not function properly, Inner ear malformations. […] There are times when CSF leaks occur as a result of very minor events: Exercise, Sneezing, Straining to have a bowel movement, Stretching, Lifting heavy objects, Coughing, Falling. […] If a CSF leak is left untreated, it may result in conditions such as meningitis an inflammation of the membranes around the brain. CSF leak due to a hole or rupture of the dura membrane may cause a condition called tension pneumocephalus. […] Your treatment options can differ depending on where the CSF leak occurred and what caused it. Your doctor may advise the first course of treatment: bed rest for a few days, hydration and elevating the head end of the bed. If this course fails, the doctor may suggest surgery to fix the leak.

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

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

  A cerebrospinal fluid (CSF) leak is an under-diagnosed, yet often debilitating, medical condition comprising a small tear or hole in the outer membrane that contains the fluid surrounding the spinal cord and brain. Or caused by a CSF-Venous Fistula (CVF), where there is an abnormal connection between the CSF space and a vein, allowing CSF to flow out into the bloodstream. […] Many people develop a CSF leak as a result of a lumbar puncture or an epidural injection or anaesthesia, while others develop them following trauma ranging from major trauma and whiplash, to minor trauma which may otherwise have gone unnoticed. […] Sometimes a CSF leak can be an unintentional consequence of an over-draining shunt, placed for the treatment of intracranial hypertension (high pressure), or as a result of underlying intracranial hypertension that has gone undiagnosed.

• #61 Cerebrospinal Fluid Leak

  https://www.icliniq.com/articles/neurological-health/cerebrospinal-fluid-leak

  Individuals affected by certain genetic disorders such as polycystic kidney disease (clusters of cysts in the kidney, a rare genetic disorder), Marfan syndrome (a genetic disorder affecting connective tissues), and Ehlers-Danlos syndrome (inherited disorder affecting blood vessels, joints, and skin) may suffer CSF leak. […] A leak may start from a torn and weak area of the dura. It may be due to a repeated sprain or pull to ones back in infrequent stretching, lifting heavy weights, falls, motor vehicle accidents, and occasions like riding on a roller coaster, which could strain the vertebra. […] Extensive drainage of CSF happens due to significant trauma and head injury. This is due to skull fractures and disruption of meninges, leading to fluid leaks through the nose and ears. This is a medical emergency requiring urgent care.

• #62 Cranial cerebrospinal fluid leaks – UpToDate

  https://www.uptodate.com/contents/cranial-cerebrospinal-fluid-leaks

  Cranial cerebrospinal fluid (CSF) leaks occur when a dural tear or defect allows the passage of CSF from the subarachnoid space into the extracranial space. […] The most common causes of cranial CSF leaks are craniofacial trauma and intracranial surgical procedures. CSF leak may also be spontaneous, due to intracranial tumors, idiopathic intracranial hypertension (IIH), or congenital skull defects. […] Cranial CSF leak is a pathologic condition caused by an abnormal communication between the subarachnoid and extradural spaces.

• #63 CSF leak: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001068.htm

  A CSF leak is an escape of the fluid that surrounds the brain and spinal cord. This fluid is called the cerebrospinal fluid (CSF). […] Any tear or hole in the membrane that surrounds the brain and spinal cord (dura) can allow the fluid that surrounds those organs to leak. When it leaks out, the pressure around the brain and spinal cord drops. […] Causes of leakage through the dura include: Certain head, brain, or spinal surgeries, Head or spine injury, Placement of tubes for epidural anesthesia or pain medicines, Spinal tap (lumbar puncture). […] Sometimes, no cause can be found. This is called a spontaneous CSF leak. […] Most CSF leaks are a complication of a spinal tap or surgery. The provider should use the smallest needle possible when doing a spinal tap.

• #64 Spontaneous Cerebro-Spinal Fluid Rhinorrhoea Caused by Sustained Intracranial Hypertension

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9129057/

  Cerebrospinal Fluid (CSF) leakage results from a defect in the skull base, which communicates the subarachnoid space with the nasal cavity. The most common cause of CSF leakage is traumatic, and non-traumatic causes are less common. […] The primary cause of CSF leak is a structural distortion due to craniofacial trauma. This makes up 80% of the leaks. 16% of CSF leaks are attributed to iatrogenic causes, while the remaining 4% include congenital defects and spontaneous leak defects. […] Non-traumatic spontaneous CSF leakage is rare and accounts for less than 5% of all reported cases. […] The pathogenesis of CSF leakage is not fully understood, but results from past studies suggest that prolonged intracranial hypertension (ICH) may cause defects in the skull base. These skull base defects alongside ICH may lead to dura mater herniation. […] Early detection and treatment play important roles in preventing complications associated with CSF leakages, such as intracranial sepsis, meningitis, and abscesses.

• #65

  https://journals.lww.com/sjoh/fulltext/2021/23030/pathophysiology_of_skull_base_defects_and.1.aspx

  The exact cause of IIH is still unknown. However, some mechanisms have been hypothesized about the impaired hydrodynamics of CSF. Researchers believe that cerebral venous hypertension and altered venous outflow are the main mechanisms in the development of IIH. […] There is a well-recognized association between body mass index (BMI) and IIH. More than 70% of IIH patients are obese, and weight loss is well known to improve symptoms of elevated ICP and CSF opening pressures. […] OSA is more prevalent in patients with spontaneous CSF leak in comparison to other CSF leak patients and the general population. […] The lateral recess of the sphenoid sinus and the cribriform plate of the ethmoid bone are the most common sites of meningoceles and spontaneous CSF leaks. […] Congenital meningoencephalocele may present as an intranasal/extranasal mass.

• #66 Brain Fluid („CSF”) Leak – SinusHealth

  https://sinushealth.com/conditions/brain-fluid-csf-leak/

  A hole or tear in the thick sac that covers the brain and spinal cord will cause the fluid around the brain to leak out. Different things can cause CSF leaks in adults. Sometimes, they have specific causes like trauma, surgery, or tumors. Other CSF leaks happen without any obvious trigger and are called spontaneous CSF leaks. Injuries cause 90% of all CSF leaks. CSF leaking out of the nose after trauma is usually seen within 48 hours of the injury but can sometimes take longer to start. Most will heal with bed rest and other conservative treatments, but surgery may be needed if the leak doesn’t stop. Injury to the lining of the brain can happen during sinus or skull surgery. If a leak is seen during surgery, it is best to fix it right away. Benign (not cancerous) tumors in the nose, sinuses, and brain rarely cause CSF leaks. Aggressive tumors and cancers can sometimes eat away at the bone between the brain and sinuses, known as the skull base. When this happens, CSF can leak out through the nose. Spontaneous CSF leaks happen when there is no trauma, surgery, or tumor that causes the leak. The most common cause of spontaneous CSF leaks is the pressure around the brain being too high. This is known as elevated intracranial pressure, or high ICP, and can be caused by many things. The high pressure around the brain slowly wears away at the bone of the skull base, causing it to be thin or missing. Sometimes, a part of the lining of the brain (meningocele) or even brain tissue (encephalocele) can stick out through the hole in the sinus or nose. A CSF leak happens when the lining eventually tears.

• #67 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. […] Headaches caused by CSF leaks usually worsen when you’re upright and improve when you lie down. […] Your brain usually weighs about 1,500 grams (3.3 pounds), but suspending it in CSF reduces its weight to about 48 grams (0.1 pounds). When you lose CSF due to a leakage, your brain can sag inside your skull. This sagging may lead to pulling against the sensory nerves in your meninges and veins, which can cause headache pain. […] CSF leak headaches often worsen when standing upright due to increased pulling against your meninges. Pain is usually relieved by lying down since there’s less pulling against your meninges and less swelling of your brain’s sinuses. […] Your brain usually compensates for low CSF pressure by expanding the blood vessels inside your brain. This process can also cause headaches due to increasing brain volume.

• #68 Cerebrospinal fluid leak | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cerebrospinal-fluid-leak?lang=us

  Cerebrospinal fluid leakage can occur at numerous sites and may be clinically occult, or result in various clinical presentations depending on the site and rate of leakage. […] The epidemiology of individuals with CSF leak will vary greatly according to the wide range of etiologies, which include: trauma (e.g. base of skull fractures, penetrating injury), iatrogenic (e.g. lumbar puncture, surgery involving the dura), tumors and infections or the skull or spine, congenital (e.g. some neural tube defects), idiopathic/spontaneous (e.g. ventral dural defects, CSF-venous fistulas). […] Clinical presentation will depend on cause and location and may either be direct evidence of the leaks or signs and symptoms related to the leak or its downstream effects. […] A common misconception is that all CSF leaks present with intracranial hypotension. This has been shown to not be the case and CSF leak from the base of skull rarely, if ever, presents with signs and symptoms of intracranial hypotension. […] The features, if any, will depend on the underlying cause as well as the location and rate of leakage. CSF may be visualized directly as fluid or the sequela of CSF hypovolemia or chronic leakage may be seen. These are discussed separately according to etiology.

• #69 Cerebrospinal Fluid (CSF) Leak | Ohio State Medical Center

  https://wexnermedical.osu.edu/ear-nose-throat/sinus-care/csf-leaks-from-anterior-cranial-base

  CSF leaks should be evaluated by specialists at Ohio State, because if left untreated, they can lead to meningitis and other serious infections. […] If this fluid begins to leak because of a hole or tear in the skull or membranes that protect the spine and brain, problems can arise. […] A CSF leak happens when the watery fluid surrounding the brain or spine begins to leak through a tear, puncture or crack in the skull or dura, the outermost membrane that protects the spine and brain. […] There are a variety of causes of a cerebrospinal fluid leak, but typically the leak occurs when there is an injury to the head or spine. […] Causes of a CFS leak include: Injury or trauma to the head, Brain, spine or skull surgeries, A lumbar puncture, also called spinal tap or spinal anesthesia (including an epidural), Malformations of the inner ear, Bone spurs on spine, Buildup of pressure in the brain. […] The cause is sometimes unknown, which is called a spontaneous cerebrospinal fluid leak. […] A CSF leak can cause serious complications, such as brain swelling and meningitis, if the condition is not treated properly.

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

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

  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. The hole or tear that causes the CSF leak may allow air to enter the space between the dura mater and the brain and spinal cord, causing a condition called pneumocephalus. If pressure builds up, you get tension pneumocephalus requiring emergency surgery. This usually occurs after trauma and is not spontaneous.

• #71 Spontaneous Cerebro-Spinal Fluid Rhinorrhoea Caused by Sustained Intracranial Hypertension

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9129057/

  Cerebrospinal Fluid (CSF) leakage results from a defect in the skull base, which communicates the subarachnoid space with the nasal cavity. The most common cause of CSF leakage is traumatic, and non-traumatic causes are less common. […] The primary cause of CSF leak is a structural distortion due to craniofacial trauma. This makes up 80% of the leaks. 16% of CSF leaks are attributed to iatrogenic causes, while the remaining 4% include congenital defects and spontaneous leak defects. […] Non-traumatic spontaneous CSF leakage is rare and accounts for less than 5% of all reported cases. […] The pathogenesis of CSF leakage is not fully understood, but results from past studies suggest that prolonged intracranial hypertension (ICH) may cause defects in the skull base. These skull base defects alongside ICH may lead to dura mater herniation. […] Early detection and treatment play important roles in preventing complications associated with CSF leakages, such as intracranial sepsis, meningitis, and abscesses.

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

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

  The timing of CSF leak is important that it will affect the long-term prognosis of the patients with other complications such as infection. […] 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.

• #73 Spontaneous Cerebro-Spinal Fluid Rhinorrhoea Caused by Sustained Intracranial Hypertension

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9129057/

  Cerebrospinal Fluid (CSF) leakage results from a defect in the skull base, which communicates the subarachnoid space with the nasal cavity. The most common cause of CSF leakage is traumatic, and non-traumatic causes are less common. […] The primary cause of CSF leak is a structural distortion due to craniofacial trauma. This makes up 80% of the leaks. 16% of CSF leaks are attributed to iatrogenic causes, while the remaining 4% include congenital defects and spontaneous leak defects. […] Non-traumatic spontaneous CSF leakage is rare and accounts for less than 5% of all reported cases. […] The pathogenesis of CSF leakage is not fully understood, but results from past studies suggest that prolonged intracranial hypertension (ICH) may cause defects in the skull base. These skull base defects alongside ICH may lead to dura mater herniation. […] Early detection and treatment play important roles in preventing complications associated with CSF leakages, such as intracranial sepsis, meningitis, and abscesses.

• #74 Cerebrospinal Fluid (CSF) Leaks: Answers to Your Frequently Asked Questions | Mount Sinai Today

  https://health.mountsinai.org/blog/cerebrospinal-fluid-csf-leaks-answers-to-your-frequently-asked-questions/

  Chances are likely that you may never have a cerebrospinal fluid (CSF) leak, but this condition affects approximately 5 in 100,000 people each year, and for many of them, it goes undiagnosed or may be misdiagnosed as a headache disorder or sinusitis. […] A CSF leak occurs when the fluid that surrounds the brain and spinal cord makes its way out of these locations and starts to drain into the nose, ear, or soft tissue around the spinal cord. This condition can be serious, if it leads to chronic headaches or a severe infection, such as meningitis. […] CSF leaks may be due to traumatic or atraumatic reasons. Trauma to the head that causes a fracture may create a tear in the lining of the brain through which CSF leakage may occur. CSF leaks may also be a result of surgical trauma in the base of the skull. Most times these are expected leaks during a tumor removal; however, less often a CSF leak may be a complication of surgery in this area. The atraumatic leak is known as a spontaneous leak and tends to occur in patients who have an elevation in their intracranial pressure. This is a similar concept to high blood pressure. The constant high pressure around the brain causes CSF to leak though weak areas in the bone that communicates with the ear and nasal cavity. […] CSF leaks should be repaired because in the setting of communication with the nose and ear, the risk of ascending infection such as meningitis is present. This infection poses a risk of permanent damage to the brain.

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