Spontaneous CSF leaks are used to refer to CSF leaks that occur suddenly, without any identifiable cause. However, often times CSF rhinorrhea is idiopathic, having no identifiable cause. Other causes of CSF rhinorrhea may be due to benign or malignant tumors of the brain. CSF leaks may also occur spontaneously secondary to underlying medical conditions such as Polycystic Ovarian Disease, or uncontrollable hypertension. CSF rhinorrhea may also be caused by head trauma, specifically those involving blunt trauma to the skull as experienced in high-speed motor vehicle collisions. Such surgeries may cause damage to the bony enclosure of the brain that leads to communication with the nose. CSF rhinorrhea may be caused by prior surgeries involving the nose, sinuses, or brain. There are many causes of leakage of CSF into the nose. Finally, the headaches may worsen when laying in different positions. Sometimes the headache may be sudden in onset, while other headaches may be subtle and long-lasting. Other symptoms include spinning sensations, vision changes, fatigue, nausea, and vomiting.ĬSF leaks, depending on the cause, may be associated with headaches. Some patients may complain of a salty metallic taste. Nasal drainage may also get worse when patients lean over or change position in bed, which shouldn’t occur with allergies or the common cold either. Allergies or sinus infections should not leak that much. Given the large amounts of CSF that the body produces daily, patients may report waking up with their pillows soaked in a clear fluid. However, certain characteristics can help distinguish CSF rhinorrhea from these other common disorders. This results in patients being placed on incorrect medications that have no impact on the drainage from the nose, causing even longer delays in diagnosis. This study shows that CSF leaks are missed with long delays in making an accurate diagnosis. A 2007 study from Cedars-Sinai demonstrated that 0% of CSF leaks were diagnosed in the emergency department, with an average delay of 8 months to accurately make the diagnosis. This is frequently initially diagnosed as allergies, the common cold, or a sinus infection. This fluid may be from both sides of the nose, but more often it is limited to only one side. Patients may complain of large amounts of clear and odorless fluid from the nose. Skull based leakage may occur from the ears or from the nose.ĬSF rhinorrhea refers specifically to leakage of brain fluid into the nose.ĬSF rhinorrhea may be difficult to diagnose due to its nonspecific symptoms that can mimic other common medical problems. This could mean the fluid that surrounds and cushions the brain leaking into your nose or ear.ĬSF may leak from the skull or from the spinal cord.
However, the body will constantly absorb and re-produce CSF at a rate of about 700 ml per day, about the same amount as a liter bottle of soda.ĬSF leak refers to leakage of the fluid from their normal bony enclosure into surrounding areas. The average adult has approximately 200 ml of CSF total circulating in their body at any given time, about the same amount as a can of soda. It acts as a soft cushioning fluid that insulates the brain and spinal cord from their hard bony enclosures.
It can sometimes be referred to as spinal or brain fluid. Cerebrospinal fluid commonly referred to as CSF, is a naturally produced fluid in the body that surrounds the delicate structures of the brain and spinal cord.
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