What causes a CSF leak?

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What causes a CSF leak?

Experts estimate that about 90% of CSF leaks happen because of injuries. The remaining 10% happen spontaneously or for unknown reasons.

Many injuries can cause CSF leaks. These include:

  • Injuries to your face, head, neck or spine. A common example of this is injuries from car crashes. The most likely injuries involve your nose, sinuses, ears, temples or the base (bottom) of your skull. Twisting or severe whiplash can also cause tears that leak CSF fluid near your spinal cord.
  • Penetrating injuries (like puncture or stab wounds, gunshot wounds).
  • Injuries from brain surgery.
  • Injuries from ear, nose and throat medical procedures.
  • Injuries from medical procedures on or around your spine, such as epidural anesthesia and spinal taps (lumbar punctures).

Non-injury causes

In about 10% of cases, CSF leaks happen for unknown reasons. However, experts have connected this problem to a few other medical conditions. Whether or not they cause CSF leaks is not yet known, but they do happen often enough that researchers are now looking to see if there is a cause-effect relationship.

  • Connective tissue disorders that could cause a weakness in the layers of tissue that should contain the CSF (examples include Marfan syndrome and Ehlers-Danlos syndrome).
  • Intracranial hypertension (high pressure inside your skull), which can cause tears in the surrounding tissue, creating a leak.
  • Pseudotumor cerebri (false brain tumors).
  • Obesity (especially class II or class III obesity).
  • Structural defects in how your nose, sinuses or other parts of your skull formed (either that you had when you were born or that developed or happened at some point in your life).

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