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A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak. [6] [7] [8] A spontaneous spinal cerebrospinal fluid leak may occur sometimes in those with predisposing heritable connective tissue disorders including Marfan syndrome and Ehlers–Danlos syndromes.
An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
Cerebrospinal fluid (CSF) is a clear, colorless transcellular body fluid found within the meningeal tissue that surrounds the vertebrate brain and spinal cord, and in the ventricles of the brain. CSF is mostly produced by specialized ependymal cells in the choroid plexuses of the ventricles of the brain, and absorbed in the arachnoid granulations .
Disruption of the dural sac may occur as a complication of a medical procedure, or as a consequence of trauma causing a cerebrospinal fluid leak, or spontaneously resulting in a spontaneous cerebrospinal fluid leak. [7] If the spinal cord is not free to move within the thecal sac due to abnormal tissue attachments, especially during growth ...
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness.
The etiology of dural ectasia is unknown, but it has been suggested that is due to increased hydrostatic pressure, [8] general weakened connective tissue [9] or as a result of the pulsatile flow of cerebrospinal fluid on weakened spinal dura. [10] Dural ectasia is common in Marfan syndrome, [3] occurring in 63–92% of people with the syndrome ...
Cerebrospinal fluid leaks can be managed short term with bed rest and plentiful hydration. They can then be treated with an epidural blood patch (EBP) with autologous blood, which is the standard initial procedure. If an EBP is ineffective, surgery is also an option for treatment.