Your central nervous system — your brain and spinal cord — relies on cerebrospinal fluid (CSF) for protection and nourishment. So if a leak develops, these functions are compromised. Thankfully, this serious condition is relatively rare, occurring in only about 5 out of every 100,000 people in the United States, but it’s still worth understanding, and recognizing, if need be.
As part of our extensive ear, nose, and throat services, Cecil Yeung, MD, and our team here at Houston Sinus Surgery in Houston provide expert treatment of CSF leaks. To help you recognize when there may be a problem, we’re taking this opportunity to review how a CSF leak can develop, what symptoms to look out for, and, most importantly, how we can resolve the problem.
The making of a CSF leak
Your brain and spinal cord are surrounded by a substance called cerebrospinal fluid, which protects these extremely delicate structures from harm. In addition to its protective role, your CSF also delivers nutrients to your brain and carts off waste through your blood.
This fluid is sealed tightly by membranes, the outermost layer of which is called the dura mater. A CSF leak typically develops when there’s a tear in the dura mater, which allows fluid to escape through the nose or ears, in most cases. There are several reasons why dura mater can tear, including:
- Trauma to your head or spine
- A lumbar puncture (spinal tap)
- Repeated epidurals or spinal catheters
- A complication following sinus or brain surgery
- Sinus tumor removal
- Connective tissue diseases
- Intracranial hydrocephalus (an abnormal buildup of fluid in your brain)
In some cases, a CSF leak can develop for no identifiable reason, which is why it’s important to recognize the signs.
Symptoms of a CSF leak
The symptoms that come with a CSF leak are hard to ignore and include:
- Nausea and vomiting
- Neck stiffness
- Heightened sensitivity to light and sound
- Vision issues (blurred or double vision)
- Loss of smell or hearing
- Fluid exiting from one nostril or one ear
- Drainage down the back of your throat
- A metallic or salty taste in your mouth
Whether you’ve experienced a head or spine trauma or not, anytime you’re experiencing any of these symptoms, it’s important that you seek our help as soon as possible, especially if you notice the presence of fluid.
Treating a CSF leak
Our first step is to identify if there’s a CSF leak, and, if there is, where it’s located. Depending on what Dr. Yeung finds, there are two treatment avenues.
In the first, we take a watchful approach and ask that you take it very easy for a week or two (bed rest!). It’s also important that you hydrate during this time, and we may provide you with IV infusions to accelerate the healing.
If conservative measures don’t work, or if the CSF tear’s location, size, or both warrant more extensive treatment, Dr. Yeung may recommend surgery. While a surgical repair of this kind may sound daunting, Dr. Yeung typically repairs the tear endoscopically through your nose, and you’re free to return home the same day.
Again, we want to emphasize that a CSF leak is relatively rare, but it’s worth understanding the problem, especially if you’re more at risk due to head trauma or interventional therapies along your central nervous system.
If you have more questions about CSF leaks, book an appointment online or over the phone with Houston Sinus Surgery today.