Recognizing the Signs of a Cerebrospinal Fluid Leak

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. 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.

At Houston Sinus Surgery, Cecil Yeung, MD, has extensive experience helping patients who’ve developed cerebrospinal fluid leaks (CFLs). If you ever get a CFL, you should be aware of the signs, so you can get treated. With that in mind, here are the most common signs that you may have developed a cerebrospinal fluid leak.

Understanding a CFL

Before we get into the symptoms of a CFL, let’s quickly review what the condition is and how it can occur. 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.

If there's a hole or tear in your dura, fluid can leak out, which is what creates a CFL. Tears or holes in your dura aren’t common, but they can occur because of:

• Head trauma
• Trauma to your spine
• Surgical complications, including sinus surgery
• Spinal tap issues
• Tumors
• Problems with epidural placements

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.

The telltale signs of a CFL

A CFL can lead to a number of symptoms, but the primary one to look out for is a positional headache. In most cases, patients develop head pain when they’re upright, and the pain tends to go away when they lie down. 

In less common cases, the head pain may be more intense when you’re horizontal rather than vertical. The takeaway here is that headaches that come and go according to your position are one of the leading signs of a CFL.

Outside of positional headaches, the symptoms of a CFL depend on whether the leak is cranial or spinal. With cranial CFLs, which is where our expertise lies, you may experience:

• Drainage from your nose
• Drainage down the back of your throat
• Drainage from your ear
• A salty or metallic taste in your mouth
• Ringing in your ears
• Changes in your vision
• Loss of smell

If you’re experiencing any of these symptoms, you should have us check you for a CFL.

Treating a CFL

If we diagnose a CFL, your treatment will depend upon the severity of the tear. In many cases, a period of rest is enough to allow time for the hole to close back up. If we determine that a surgical repair is the better option, Dr. Yeung will perform the procedure endoscopically through your nose.

If you suspect you may have a CFL, book an appointment online or over the phone with Houston Sinus Surgery.