CEREBROSPINAL FLUID LEAK

Course overview

CEREBROSPINAL FLUID (CSF) IS A CLEAR PROTEIN- AND GLUCOSE-RICH LIQUID IN THE SUBARACHNOID SPACE OF THE CENTRAL NERVOUS SYSTEM. IT IS FOUND IN THE VENTRICLES, SURROUNDING THE BRAIN, AND WITHIN THE CENTRAL SPINAL COLUMN. CSF REGULATES CENTRAL NERVOUS SYSTEM TEMPERATURE, CUSHIONS THE BRAIN AND SPINAL CORD, AND PROVIDES A DELICATELY BALANCED BUOYANT FORCE THAT ALLOWS THE BRAIN TO RETAIN ITS SHAPE AND CIRCULATORY INTEGRITY DESPITE ITS WEIGHT AND LACK OF INTRINSIC RIGID SUPPORT. A LEAK IN THIS SYSTEM, THEREFORE, CAN BE DETRIMENTAL TO BRAIN BLOOD SUPPLY AND FUNCTION AND CAN INCREASE THE RISK OF DIRECT TRAUMA TO BRAIN PARENCHYMA DUE TO LOSS OF FLUID CUSHION. ADDITIONALLY, THE PRESENCE OF CSF LEAK INDICATES THE NEED FOR FURTHER EVALUATION AND MANAGEMENT AS IT MAY BE DUE TO A FRONTOBASILAR OR TEMPORAL SKULL FRACTURE. OPEN COMMUNICATION OF THE SUBARACHNOID SPACE WITH CSF LEAK PRESENTS A PATHWAY FOR LIFE-THREATENING CNS INFECTION INCLUDING MENINGITIS. THIS ACTIVITY REVIEWS THE ETIOLOGY, PRESENTATION, EVALUATION, AND MANAGEMENT OF CSF LEAKS, AND REVIEWS THE ROLE OF THE INTERPROFESSIONAL TEAM IN EVALUATING, DIAGNOSING, AND MANAGING THE CONDITION.