Headaches are among the most common symptoms of a cerebrospinal fluid (CSF) leak. They may develop due to nerve irritation in your meninges.
CSF leaks usually occur when the outer layer of your meninges, called the dura, experiences a puncture during surgery or from a head injury. Your meninges are three protective tissue layers covering your brain and spinal cord.
Headaches caused by CSF leaks usually worsen when you’re upright and improve when you lie down. Some people may develop thunderclap headaches, which are debilitating headaches that occur suddenly.
This article reviews why CSF leaks cause headaches and what these headaches might feel like.
Learn more about CSF leaks.
Headaches may occur in more than
An orthostatic headache is a headache that’s worse when you’re vertical and improves when you’re lying down. It usually occurs or worsens within
Studies used in a 2023 case report showed that
A CSF leak requires emergency medical attention. Get immediate care if you develop a sudden and severe headache or other potential symptoms such as:
- changes in your vision
- confusion
- weakness
It’s vital to receive medical help if you’ve recently had:
- a head injury
- a spinal tap
- brain surgery
For mild CSF leaks, your doctor may recommend:
- getting complete bed rest
- taking ibuprofen (Advil) and acetaminophen (Tylenol) for headache and neck pain
- drinking plenty of hydrating fluids
- avoiding activities that increase pressure in your head
- increasing caffeine and salt intake slightly
More severe leaks may need:
- surgery, which has high rates of success
- blood patch injections
- antibiotics or other medications
If your doctor suspects a CSF leak, they can have you get imaging such as:
Your brain usually weighs about
CSF leak headaches often worsen when standing upright due to increased pulling against your meninges. Pain is usually relieved by lying down since there’s less pulling against your meninges and
Your brain usually compensates for low CSF pressure by expanding the blood vessels inside your brain. This process can also cause headaches due to increasing brain volume.
Other common symptoms of a CSF leak include:
- clear nasal drip
- nausea
- neck pain and stiffness
- ringing in your ears
- loss of smell
- loss of taste
The outlook for a CSF leak is usually good when you manage the leak properly — success rates of initial endoscopic surgery range from
How long can a CSF leak go untreated?
The average time from first symptoms to diagnosis of a cerebrospinal fluid leak is 2 1/2 months. This condition can be challenging to diagnose, and people may live with symptoms for a long time before they receive accurate diagnoses and appropriate treatments.
Some cerebrospinal fluid leaks resolve within a few days, even without surgery. However, getting medical attention for a proper evaluation is still essential if you suspect you might have a CSF leak.
How do you check for a CSF leak at home?
You can’t diagnose a CSF leak at home. Get immediate medical attention if you have potential symptoms, such as a headache that worsens when you stand up and improves when you lie down.
Should I go to the ER for a CSF leak?
Most CSF leaks are treatable. But go to the emergency room (ER) for proper evaluation and management if you have possible symptoms.
Headaches are one of the most common symptoms of CSF leaks. They may occur due to irritation of the nerves in your meninges.
Getting immediate medical attention is essential if you think you may have symptoms of a CSF leak. Although they’re almost always successfully treatable, they still require a prompt diagnosis to avoid complications like meningitis.