What can mimic a CSF leak?
POTS, orthostatic hypotension, cervicogenic headache, vestibular migraine, and prior Chiari decompression surgery are all causes of orthostatic headache that may mimic spinal CSF leak and must be distinguished for patients to receive appropriately directed therapy.
What does a CSF leak feel like?
The most common symptoms of a spinal CSF leak are: Positional headaches, which feel worse when sitting upright and better when lying down; caused by intracranial hypotension. Nausea and vomiting. Neck pain or stiffness.
Can CSF leak symptoms come and go?
Patients who have had a CSF leak have described the fluid as having a salty or metallic taste. Dr. Frank P.K. Hsu, chair of the department of neurological surgery at UC Irvine Health, said that the fluid may also “come and go.”
Can a CSF leak cause brain fog?
Other common symptoms which may accompany the headache include nausea and vomiting, neck pain and stiffness, changes in hearing (muffled, underwater, tinnitus), sense of imbalance, sensitivity to light or sound, interscapular pain, brain fog, dizziness or vertigo.
How rare is a spontaneous CSF leak?
A spontaneously occurring spinal CSF leak is currently considered rare, meaning that fewer than 200,000 patients in the USA currently suffer with this disorder. Due to infrequent recognition, it has been difficult to study how often this occurs with accuracy. It may be more common that we know.
When should you suspect a CSF leak?
Conclusion. Spontaneous CSF leak is an uncommon but potentially highly debilitating cause of headaches. Given that a number of effective therapies are available, it is important for clinicians to consider this diagnosis, particularly when there is a history of orthostatic headache.
What do you do if you suspect a CSF leak?
If a leak is suspected, referral to a specialist with expertise in this area is recommended. This may be a neurologist (particularly those with an interest in headaches), neurosurgeon or neuroradiologist. Many patients will undergo a CT brain early in their presentation that may be reported as normal.
How serious is a CSF leak?
A CSF leak is a serious issue that can cause complications such as headaches, meningitis, and seizures.