Length of stay in the hospital depends on the size of the leak — most patients are in the hospital for a few days after surgery. Some patients may require a lumbar drain that is removed before going home. Ear CSF leak closure requires cutting the skin behind the ear and removing portions of mastoid honeycomb-like, bony tissue to access the source of the CSF leak around the ear.
Using your own tissue or a biomaterial graft, the surgeon repairs the leak and seals the surgical opening. For CSF leaks that drain into the spinal canal, there are other treatments, such as use of blood or fibrin patches.
This can often repair the leak. If these methods fail, duraplasty — surgical repair of the dura — may be necessary. Physicians have long known that rising intracranial pressure may help create leaks. Now, a multidisciplinary team is developing protocols to better monitor rising pressures, especially in postsurgical patients. Health Home Conditions and Diseases. What is cerebrospinal fluid? What is a CSF leak? Analysis of the nasal fluid: This test is used to detect beta-2 transferrin, a protein found almost exclusively in CSF.
A lumbar puncture generally takes less than 30 minutes. CSF is usually taken from your lower back area, or the lumbar spine. This way you avoid incorrect needle placement or trauma to your spine. You may be seated and asked to lean over so that your spine is curled forward. Or your doctor may have you may lie on your side with your spine curved and your knees drawn up to the chest.
Curving your spine makes a space between your bones in the lower back. Iodine is often used for cleaning. A sterile area is maintained throughout the procedure. This reduces the risk of infection. A numbing cream or spray is applied to your skin. Your doctor then injects anesthetic. Once the site is fully numb, your doctor inserts a thin spinal needle between two vertebrae.
A special type of X-ray called fluoroscopy is sometimes used to guide the needle. First, the pressure inside the skull is measured using a manometer. Both high and low CSF pressure can be signs of certain conditions. Fluid samples are then taken through the needle. When fluid collection is complete, the needle is removed. The puncture site is cleaned again.
A bandage is applied. This reduces the risk of a headache, which is a common side effect of the procedure. In these cases, a more invasive CSF collection method that requires hospitalization might be used, such as one of the following:. CSF collection is often combined with other procedures. For example, dye might be inserted into your CSF for a myelogram. This is an X-ray or CT scan of your brain and spine.
People who take blood thinners have a heightened risk of bleeding. Lumbar puncture is extremely dangerous for people who have clotting problems such as a low platelet count, which is called thrombocytopenia. There are serious additional risks if you have a brain mass, tumor , or abscess. These conditions put pressure on your brain stem.
A lumbar puncture could then cause brain herniation to occur. This can result in brain damage or even death. Brain herniation is a shifting of structures of the brain.
The condition eventually cuts off blood supply to your brain. This causes irreparable damage. It may also be used if you have cancer and your doctor wants to see if the cancer has spread to the CNS.
CSF analysis can accurately distinguish between a wide range of CNS diseases that can otherwise be difficult to diagnose. Conditions found by CSF analysis include:. Viruses, bacteria, fungi, and parasites can all infect the CNS.
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