If the membrane that surrounds the brain and spinal cord tears or punctures, “spinal fluid” (or its medical term, cerebrospinal fluid [CSF]) contained by the membrane can leak and cause infection and further complications, including meningitis.

Causes of CSF leak include:

  • Brain, skull or spinal surgeries
  • Injury or trauma to the head
  • Spontaneous intracranial hypertension


Cerebrospinal fluid can leak into the sinuses and through the throat, one of the ears or one side of the nose. It has often been described as tasting salty. Nasal drainage of clear watery fluid is the most common symptom. Your physician may confirm the condition through a number of tests, including CT and MRI scans.


Cerebrospinal fluid leaks with or without symptoms need to be treated, although not all cases require surgery. Depending on the cause, some leaks can heal within a matter of days. If there is infection, fever or change in mental status after brain or spinal cord surgery, it is considered a medical emergency that requires immediate attention and antibiotic treatment. Other serious complications include meningitis. If the leak does not heal on its own, surgery may be necessary to patch the site of the leak.

During surgical procedure

When surgery is required to stop a cerebrospinal fluid leak, a graft of the patient’s own tissue is usually used to patch the site of the leak. Repair of the membrane can be conducted through the nasal cavity using a small scope called an endoscope. Previous scans can be utilized through a computerized “surgical GPS” during surgery to identify anatomy and help ensure accidental surgical injury is avoided. Electrophysiological monitoring of brain function and nerves during surgery may also be used to detect changes in the patient and prevent injury.

There are various advantages to performing this surgery through the nose as opposed to through the cranium (craniotomy). Surgical trauma, the risk of complications and recovery time for the patient are usually reduced. Our surgeons specialize in this type of procedure and utilize it whenever possible.


The surgery is performed under a general anesthetic and a one- or two-night hospital stay is usually required, depending on the extent of the repair. Strenuous physical activity is to be avoided for at least three weeks. Other restrictions are recommended, including:

  • Avoid constipation
  • Limit the objects you carry to only those weighing under 10 pounds
  • No bending over/picking up objects off the floor
  • No nose blowing and be sure to sneeze with an open mouth

Why Choose Ohio State

Expertise and training: We are a referral center for complex procedures because we perform them on a daily basis. As fellowship-trained specialists, all our physicians have extensive hands-on experience with treating the entire range of disorders of the nose, sinuses and skull base, from routine to complex.

Comprehensive care: Our approach is a multidepartmental collaborative effort, involving various specialists from around our medical center. In the case of repairing CSF leaks, skull base surgeons work together with neurosurgeons to achieve the best outcomes for our patients. This comprehensive care is a hallmark of our service.

Patient-centered: Ohio State' Wexner Medical Center is recognized for our outstanding patient service and satisfaction. 

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