Image: Two-level epidural blood patch © Wouter I. Schievink, MD
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Image: Two-level epidural blood patch © Wouter I. Schievink, MD


Today is DAY 6 of Spinal CSF Leak Awareness Week.

Our focus for today is: Treatment of spinal cerebrospinal fluid (CSF) leak, also known as intracranial hypotension.


Treatments for spinal CSF leaks vary from conservative to surgical procedures. The specific clinical situation will dictate the course of action. Symptom severity and complications influence intervention. Some serious complications (which occur rarely) will necessitate emergent and more aggressive intervention.

This short video with Dr. Wouter Schievink talks about treatments.

Conservative Treatment

Some patients have symptoms that resolve spontaneously in a matter of hours, days or weeks without ever seeking or requiring medical care. Conservative measures such as plenty of fluids, caffeine and bedrest might be used for a period of time before proceeding to a procedure.

Spinal Injection Procedures

The mainstay of treatment is an epidural blood patch. The patient’s blood is injected into the epidural space, the space just outside the dura within the spinal canal. One or more EBPs may be curative but in some patients, the symptoms relapse.

A substantial percentage of patients respond favorably to one or more epidural patching procedures. When epidural blood patching is unsuccessful or if symptoms recur, spinal imaging findings help to guide further treatment.

Epidural patching may also be performed with fibrin sealant or a combination of fibrin sealant and blood. This type of patching is directed at known or suspected leak locations based on spinal imaging.


Surgical repairs may be necessary for patients that have not responded to spinal injection procedures or when the leak is of a nature that is unlikely to respond to less invasive procedures. Surgery is tailored to the type and location of the leak and has good success rates in the hands of experienced neurosurgeons.

For more information, visit our information page on Treatment and review our document on Treatment

This evening visit our facebook page to see photos of landmarks and buildings shining purple in honor of #leakweek.
BC Place – Vancouver, BC
US Bank Tower – Los Angeles, CA
Rundel Memorial Building – Rochester, NY
Building Owners and Managers Association (BOMA) of Chicago – Chicago, IL
King & Queen Buildings at Concourse – Atlanta, GA

Don’t miss today’s Expert LIVE Q & A session with Dr. Wouter Schievink at 11 am PST / 2 pm EST on our facebook page and mark your schedule for the sessions tomorrow and Friday.