Is it possible to leak spinal fluid

The brain and spinal cord are surrounded by three protective membranes, the outermost of which is called the dura. One function of the dura is to contain the cerebrospinal fluid CSF —the liquid that bathes and cushions the brain and spinal cord.

A spinal fluid leak occurs when CSF escapes from the dura. Spinal fluid leaks can occur for a variety of reasons. Some are due to a congenital defect in the dura a defect present at birth. Neurologic complications of common spine operations. Benzel's Spine Surgery. Philadelphia, PA: Elsevier; chap Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. Bradley's Neurology in Clinical Practice.

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This article describes the causes and symptoms of a CSF leak. It also looks into how doctors diagnose and treat the issue and what to expect during recovery. According to the Spinal CSF Leak Foundation , the most common symptom of a CSF leak is an upright headache — a headache that worsens when the head is in an upright position, as when a person is sitting or standing. These headaches usually improve when the person lies down.

Sometimes, the position of the head does not directly affect the severity of the headache. Instead, a person may experience a headache that worsens throughout the day. An individual with a CSF leak may also notice clear, watery fluid draining from their nose or ears when they move their head, especially when bending forward. CSF may also drain down the back of the throat.

People describe the taste as salty and metallic. 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, causing a CSF leak. Other causes of a CSF leak — in the skull or spine — include:. One test involves placing a sample of what the doctor suspects to be CSF discharge on a piece of filter paper.

Once in contact with the paper, any CSF will separate from any blood or mucus. A healthcare professional can often identify CSF just by looking at a sample on a handkerchief or piece of gauze. Unlike mucus, which is thick and sticky, CSF is clear and watery. Compared with mucus, CSF also has a high concentration of glucose. Checking the glucose levels in nasal discharge can help determine whether it contains CSF.

Any sample of discharge that contains CSF can indicate a leak. Treatment for a CSF leak depends on its severity and the cause. Some leaks respond to conservative treatment, while others require more invasive approaches. A CSF leak that does not respond to conservative treatment may require more invasive approaches, such as those below.

Diagnosing a CSF leak includes an analysis of the nasal fluid for a protein called beta-2 transferrin which is most only found in cerebrospinal fluid. CT and MRI scans may also be require to determine the location and severity of the leakage. Two further diagnostic tests may also be performed to assist in the diagnosis of the CSF leak: a coronal CT cisternogram and a pledget study. A pledget study involves placing small cotton pads called "pledgets" into the nose.