Medical Guidelines

Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension

The CSF Leak Association feel strongly that there needs to be a consistent pathway for patients with SIH, so that every patient gets the best possible treatment at the earliest opportunity. It has been luck and location which has determined the possible investigation, treatment and management patients may receive when they present with a SIH/spinal CSF leak.

For those reasons, the charity was excited to work with medical professionals and patients across the UK, who have experience in SIH/spinal CSF leaks to deliver the first consensus guideline for SIH.

The aim was to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).

A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives, and for more than two years, they worked with patients and the CSF Leak Association to deliver this much needed guideline.

This guideline was first published in the Journal of Neurology, Neurosurgery and Psychiatry, May 2023

Consensus Practice Guidelines on Postdural Puncture Headache From a Multisociety, International Working Group

No members of the CSF Leak Association, our Medical Advisory Committee or any associated medical professionals or patient representatives were involved in this consensus statement.

Postdural puncture headache (PDPH) can follow unintentional dural puncture during epidural techniques or intentional dural puncture during neuraxial procedures, such as a lumbar puncture or spinal anesthesia. Evidence-based guidance on the prevention, diagnosis, and management of this condition is, however, currently lacking.

These guidelines were created to fill the practice guidelines void and provide comprehensive information and patient-centric recommendations for preventing, diagnosing, and managing PDPH.

This guideline was first published in the JAMA Network Open, August 2023

International Forum of Allergy and Rhinology

No members of the CSF Leak Association, our Medical Advisory Committee or any associated medical professionals or patient representatives were involved in this consensus statement.

During recent years, an association between spontaneous cranial CSF leak/rhinorrhea and idiopathic intracranial hypertension (IIH) has been recognised. However, there is still varying opinion regarding the assessment, investigation, and management of patients with spontaneous CSF rhinorrhea.

The authors of this consensus statement are experts from Europe, Asia, Australia, South and North America. This guideline was first published in the International Forum of Allergy and Rhinology, October 2020.

They state, "Although by no means comprehensive and final, we believe they can contribute to the standardization of clinical practice. Early diagnosis, prompt surgical closure of the defect, assessment for and treatment of potentially co‐existing idiopathic intracranial hypertension in a comprehensive multidisciplinary approach are essential in order to successfully manage spontaneous CSF rhinorrhea, reduce associated morbidity and prevent recurrence."