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