Brain Tumors and Skull Base Tumors | Pituitary Adenomas | Cerebrospinal Fluid Leaks
Cerebrospinal Fluid (CSF) Leaks
OVERVIEW:
Cerebrospinal fluid (CSF) is constantly made by the brain and reabsorbed into the blood system. On occasion, as a result of a skull fracture, weakness of the brain covering (dura), intracranial surgery or growth of a brain tumor, CSF may leak through the brain covering. This is a potentially dangerous condition that can lead to an infection of the CSF (meningitis) or of the brain itself (brain abscess). One of the more common complications of transsphenoidal surgery is a post-operative CSF leak. As shown Dr. Kelly’s recent experience, CSF leaks that occur at the time of surgery require careful repair to avoid a post-operative CSF leak. Using this methodology, the chance of a post-operative CSF leak should be no greater than 1-2%.
SYMPTOMS:
A CSF leak is usually associated with watery clear drainage out of the nose, ear canal or out of a surgical incision. If meningitis has occurred, headache, stiff neck and photophobia (sensitivity to light) may occur; other symptoms such as weakness, in-coordination and confusion may occur.
DIAGNOSIS:
The diagnosis of a CSF leak is made by noting watery drainage out of the nose, the ear canal or a surgical incision. A brain MRI or CT scan may also show from where the CSF leak is originating and may reveal intracranial air (pneumocephalus). A CT scan with injection of a contrast agent through the lumbar spine (a spinal tap) can also be helpful in localizing the origin of a CSF leak and dural defect. In some instances, it may be difficult to determine if fluid from the nose or ear is actually CSF. In such instances, a sample of the fluid can be collected and tested for a compound found only in the CSF called Beta-2 transferrin.
