The following summary of imaging techniques and investigative tests draws upon research presented in a wide variety of medical papers. brain sag or pachymeningeal enhancement), or identify pockets of cerebrospinal fluid outside the dura mater. Even where scans are unable to locate a leak site, they may be able to disclose the symptoms that help to confirm diagnosis, such as intracranial hypotension with spinal leaks (e.g. While it is sometimes possible to resolve spontaneous spinal CSF leaks through high-volume ‘blind’ blood patches where the leak site is not known (the success rate is thought to be around 40%), in many cases establishing precise location of the hole or tear can be critical to proper management and enables more directed treatment.Ī variety of imaging techniques, scans and investigations can be undertaken to determine where CSF is leaking – some are more successful than others. If you suspect you may have a CFL, book an appointment online or over the phone with Houston Sinus Surgery.Where a CSF Leak is suspected as a result of symptoms or patient history, establishing the precise location of the leak is generally the next step. Yeung will perform the procedure endoscopically through your nose. If we determine that a surgical repair is the better option, Dr. In many cases, a period of rest is enough to allow time for the hole to close back up. If we diagnose a CFL, your treatment will depend upon the severity of the tear. If you’re experiencing any of these symptoms, you should have us check you for a CFL. A salty or metallic taste in your mouth.With cranial CFLs, which is where our expertise lies, you may experience:
Outside of positional headaches, the symptoms of a CFL depend on whether the leak is cranial or spinal. The takeaway here is that headaches that come and go according to your position are one of the leading signs of a CFL. In less common cases, the head pain may be more intense when you’re horizontal rather than vertical. In most cases, patients develop head pain when they’re upright, and the pain tends to go away when they lie down. The telltale signs of a CFLĪ CFL can lead to a number of symptoms, but the primary one to look out for is a positional headache. In some cases, CFLs can develop for unknown reasons, or they may stem from a problem called high-pressure hydrocephalus, which is when you have an abnormal accumulation of cerebrospinal fluid. Surgical complications, including sinus surgery.Tears or holes in your dura aren’t common, but they can occur because of: If there's a hole or tear in your dura, fluid can leak out, which is what creates a CFL. As we mentioned, your brain and spinal cord are surrounded by a protective and supportive fluid, which is contained by a tough membrane called your dura. Understanding a CFLīefore we get into the symptoms of a CFL, let’s quickly review what the condition is and how it can occur. With that in mind, here are the most common signs that you may have developed a cerebrospinal fluid leak. If you ever get a CFL, you should be aware of the signs, so you can get treated. When a leak occurs, your brain and spinal cord not only lose some of this protection, but you may experience a wide range of side effects.Īt Houston Sinus Surgery, Cecil Yeung, MD, has extensive experience helping patients who’ve developed cerebrospinal fluid leaks (CFLs). Your brain and spinal cord owe much of their ability to function to the fluid they’re bathed in, which protects and cradles these highly sensitive structures.
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