Mecklenburg Radiology

Cerebrospinal fluid leak (CSF)

Cerebrospinal fluid, or CSF, refers to the clear fluid that lines and protects the brain and spinal
cord. This fluid serves many purposes, including cushioning the brain and spinal cord, providing
nutrients, and removing toxins. Any tear of the dura, the tissue which lines the brain and spinal
cord, can cause a leak of CSF. This can occur following procedures such as lumbar punctures
and spinal anesthesia, trauma, surgery, or can occur spontaneously, especially in the setting of
connective tissue diseases such as Ehlers-Danlos syndrome. CSF leaks cause a decrease in
intracranial pressure, which can result in unrelenting, debilitating headaches.

How do we diagnose a CSF leak?

MRI
Magnetic resonance imaging, or MRI, is a noninvasive tool for identifying CSF leaks. MRI uses a
magnetic field to produce highly detailed images of the spine. MRI does not use radiation and is
not associated with radiation risks.

CT Myelography
Computed tomography, or CT scans, can be used to diagnose CSF leaks. CT scanners use a series
of x-rays and advanced computers to create images of the brain and spine. A related technique
called CT myelography adds contrast dye injected into the spinal canal to identify the site of a
CSF leak.

How do we treat a CSF leak?

Once the site of a CSF leak has been identified, minimally invasive techniques can successfully
be used to patch the leak and prevent further symptoms. Most commonly, a sample of the
patient’s blood is drawn, processed, and then injected at the site of the leak. This procedure is
typically performed under the guidance of CT. Alternatively, a man-made sealant can be
injected with the same technique in order to patch the CSF leak.