Treatment

NB. The content of this section is temporary and will be updated shortly. Common treatments for a CSF leak include:

Conservative

  • Bed rest
  • Hydration (2-3 litres per day)
  • IV Caffeine infusions
  • Strong coffee or caffeine tablets

Invasive

An epidural blood patch, where blood is drawn from the patient and immediately injected into the epidural space, is the most common invasive treatment. Where the leak site is known, blood will be injected as close to it as possible. Where the leak site is not known, a high volume blood patch (typically 20ml) is injected into the lumbar spine (very occasionally, the thoracic). Blood patches are generally thought to be safe, but occasional reports of increased CSF pressure, persistent epidural fluid collections, nerve damage and infection have been reported.

Fibrin glue can be applied in much the same way as a blood patch to seal a known CSF leak site. Fibrin glue is often used where a blood patch repeatedly fails.

A surgical repair may be performed where a patient fails to respond to a blood patch or a blood patch fails, if the site of the leak has been identified. Surgical repairs can include suturing and the use of aneurism clips. If the site is not known, but an area is suspect, exploratory surgery may sometimes be possible, with any discovered leak being repaired as above.