Osteopathy: be aware of a cerebrospinal leak

What is a cerebrospinal leak?

A CSF leak is a tear or hole in the membrane containing CSF.

When fluid leaks out at spinal level, pressure and fluid volume around the brain reduces (known as intracranial hypotension) which allows the brain to sag within the skull.

A CSF leak occurring at cranial level is thought not to trigger intracranial hypotension, but nonetheless can give rise to a variety of symptoms, such as headache, visual disturbance and changes to hearing or ringing in the ears, as well as external CSF discharge, commonly to the throat and nose.

Meningitis risk is also elevated with a cranial CSF leak.

Possible causes:

Many people develop a CSF leak as a result of a lumbar puncture or an epidural injection or anesthesia, while others develop them following trauma, ranging from major trauma and whiplash, to minor trauma which may otherwise have gone unnoticed.

A wrong nose swap for Covid detection can also be the cause.


• Headache.
• Pressure feeling.
• Visual disturbances.
• Hearing problems.
• Tinnitus.
• Spasms.
• Seizures.
• Orthostatic hypotension.
• Dizziness.
• Orthostatic tremor.
• Positional vertigo.
• …

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