Spinal cerebrospinal fluid (CSF) leak is an important and under-diagnosed cause of new onset headache that is treatable and often curable.
Cerebrospinal fluid (CSF) is a special fluid that bathes and supports the brain and spinal cord. When the tough layer called the dura that holds CSF in around the brain and spinal cord has a hole or tear, this results in a loss of CSF through the defect.
While there are a number of symptoms, the most common symptom is an “upright headache”, that is, a headache that is worse when upright, improved lying flat, or a headache that gets worse as the day goes on. Most of the time, this is mistaken as a migraine headache, or is attributed to another cause. Many patients are quite disabled by their limited functional upright time each day. Very rarely, this can be life-threatening.
Spinal CSF leak is a diagnosis that tends to be missed when it occurs out of the blue, while cases that arise after medical procedures like spinal taps and spinal surgery are usually recognized more quickly.
BUT, this is a type of headache that offers the hope of a cure. Like a plumbing leak, a spinal CSF leak can often (but not always) be fixed. With the right diagnosis and access to the right testing and treatments, more patients will have an improved quality of life.