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A CSF leak occurs when a tear or hole forms in the membrane that surrounds the brain and spinal cord. This allows the cerebrospinal fluid (CSF), which supports and bathes the central nervous system, to seep out.
There are two main categories of CSF leak - spinal and cranial - and whilst there can be some overlap, causes can vary between the two.
What causes a spinal CSF leak?
- Some brain or spinal surgeries;
- Major trauma head and spinal injuries;
- Minor trauma, such as a sneeze, a violent cough or twist;
- Placement of tubes for spinal and epidural anaesthesia or pain medications;
- Lumbar punctures (also known as spinal taps) and lumbar drains;
- Shunts inserted for hydrocephalus and similar conditions; and
- Underlying connective tissue disorders, such as the Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorders (HSD).
Sometimes no cause can be found or identified, but a spinal CSF leak is nonetheless suspected. This is known as a Spontaneous CSF leak or Spontaneous Intracranial Hypotension (sometimes abbreviated to SIH).
Sometimes no cause can be found or identified, but a spinal CSF leak is nonetheless suspected.
What causes a cranial CSF leak?
- Some head or brain surgeries;
- Major trauma and head injuries;
- Minor trauma, such as a sneeze or a violent cough;
- Defects in the skull, including the skull base and in/around the sinuses;
- Shunts inserted for hydrocephalus and similar conditions; and
- Underlying and untreated intracranial hypertension (excessive intracranial pressure).
Sometimes no cause can be found or identified, but a cranial CSF leak is nonetheless suspected. This is known as a Spontaneous CSF Leak.
Last reviewed: 2021
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