A cerebrospinal fluid leak or CSF leak is a severe condition that can be misdiagnosed as sinusitis or migraine. It can occur at any age, but spontaneous CSF leaks of the nose tend to occur among people who are 30 and older and are more likely to affect women than men.
If left undiagnosed or untreated, this issue can cause headaches and a persistent runny nose. Serious potential conditions, like meningitis and even brain infections, are also possible. To learn more about CSF leaks of the nose and how it relates to sinus infections, keep reading.
CSF Leaks Explained
CSF is a clear liquid that surrounds the brain and spinal cord to protect them from injuries. These leaks can cause several issues that impact the spine and the brain.
The most common cause of CSF leaks is a hole in the dura. This results in fluid leaking out through the ears or nose. Even minor, microscopic cracks between the brain and sinus can trigger CSF leaks.
It’s also important to note that leaks can occur anywhere in the brain or spinal cord. If you have blood pressure issues or other pre-existing medical conditions, the chances of developing CSF leaks are higher.
Symptoms of Nasal CSF Leaks
The signs and symptoms of CSF leaks could include headaches and clear, watery discharge from your nose. Some of the most common symptoms of CSF leaks include:
- Headaches
- Neck or shoulder pains
- Clear or yellow nasal discharge
- Nausea and light sensitivity
- Arm pain and problems with balance
- Vomiting, dizziness, nausea, and exhaustion
You might find that some of these symptoms are similar to the symptoms of sinus infections or even migraines.
Can Sinus Infections Cause a CSF Leak?
CSF leaks are often mistaken for adult sinusitis, since one of its main symptoms is nasal drainage—a symptom shared by sinusitis. A complication of sinusitis can be a CSF leak if the infection invades the skull base. Trauma and head or sinus surgery can also be a culprit.
Sinus surgery is a common procedure, but one of the risks of it includes damaging the bony skull base and the lining of the brain, which can cause the fluid to leak through the nose. Fortunately, this is a relatively rare complication of sinus surgery.
Diagnosis and Treatments
Doctors diagnose nasal cerebrospinal fluid leaks using beta-2 transferrin analysis of the secretions, CT myelography tests, endoscopies, and scans. You will also go through detailed physical and medical history examinations.
The treatment for CSF leaks will vary based on the location and size of the defect associated with the CSF leak. Some leaks get better with bed rest alone, while more severe leaks call for surgical procedures to repair the holes in the skull associated with the leaks.
Bed Rest
You may need bed rest to recover from a CSF leak. It is also critical to visit your doctor regularly since CSF leaks could trigger meningitis.
Nasal Endoscopy
This procedure is a minimally invasive tool in which the doctor inserts a thin, flexible tube with a light into your nose to look for signs and locations of the brain fluid leak.
Epidural Blood Patch and Sealants
Samples of your own blood are injected into your spine, so the blood cells form a clot that covers the area of the leak. Alternatively, doctors may also inject special sealants into the spine to cover the leak.
Transvenous Embolization for CSF-Venous Fistulas
This procedure may be an option for symptoms of spontaneous intracranial hypotension.
Endoscopic CSF Leak Repair
Your doctor may recommend surgery to treat the CSF leak. Paranasal sinus CSF leaks can usually be repaired endoscopically through the nose by isolating the area of the CSF leak and using tissue from your body to seal the defect.
Please visit our website for more information on CSF leaks, symptoms, and treatments. Our goal at Sinus Health is to encourage excellent patient care by delivering the right information to them, right at their fingertips.