Cerebrospinalvæskelekkasje

Cerebrospinalvæskelekkasje, also known as cerebrospinal fluid (CSF) leak, refers to the abnormal escape of cerebrospinal fluid from its normal containment within the subarachnoid space surrounding the brain and spinal cord. This condition typically occurs due to a defect or tear in the dura mater, the outer membrane that encases the CSF, or as a complication following trauma, surgical procedures, or spontaneous dural tears.

Symptoms of a CSF leak often include headaches that worsen when upright and improve when lying down, neck stiffness, nausea, and sometimes visual disturbances. In cases where the leak occurs through the nose or ear, patients may observe clear fluid drainage from these passages, which is often confirmed by testing for the presence of CSF-specific proteins or glucose.

Diagnosis involves clinical assessment, imaging studies such as MRI or CT scans, and fluid analysis to identify the leak and its location. MRI with myelography can be particularly useful for locating leaks in the spinal region.

Treatment varies based on the severity and location of the leak. Conservative management, including bed rest, hydration, and caffeine intake, may be sufficient in minor cases. Persistent or large leaks often require surgical intervention to repair the dura mater and stop CSF escape. Endoscopic techniques are increasingly used for spinal and cranial repairs.

Complications of untreated CSF leaks can include infection such as meningitis, persistent headaches, and neurological deficits. With timely diagnosis and appropriate treatment, prognosis is generally favorable. Ensuring proper management is crucial to prevent serious secondary issues related to CSF loss.