Cerebrospinal Fluid (CSF) Leaks

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Cerebrospinal fluid (CSF) is a mixture of water and electrolytes that circulates the brain and spinal cord. A CSF leak through the nose may be caused by a disruption in the lining of the brain, or in the bone that separates the brain from the sinuses. Most often, the CSF drainage will appear as a noticeable clear nasal drip when leaning or bending over, or arising from a laying position.

Causes of Cerebrospinal Fluid Leaks

Cerebrospinal fluid is produced in an area within the brain called the choroid plexus. This structure continuously replenishes this fluid to ensure the safety of the brain. A CSF leak can be arise from several different causes, including:

  • Intracranial pressure that causes the thinning of the bone between the brain and the sinuses
  • A blow, or trauma, to the head or face that causes the bone between the brain and the sinuses to fracture
  • Surgical accidents in which an inexperienced surgeon accidentally penetrates the sinus bones while operating (though this is very rare)

Symptoms of Cerebrospinal Fluid Leaks

Symptoms of a cerebrospinal fluid leak include:

  • Severe headaches when standing or sitting upright, that alleviate when lying down
  • Watery nasal drip that has a salty taste
  • Clear, watery nasal drainage from only one side of the nose, that is worsened when getting up from a seated or lying position
  • Newly onset neck stiffness

Cerebrospinal Fluid Leaks Treatment

During treatment, your rhinologist will often collect and test your nasal drip to see if it contains beta-2 transferrin, a protein unique to CSF. A CT scan may also be used to asses your condition more closely. Additionally, your surgeon may also perform a nasal endoscopy to look inside your nasal structures to pinpoint exactly where the leak is coming from.

A small leak may be treated with a lumbar spinal drain, in the hopes that the leak will resolve on its own. However, if the leak persists after the drain placement, surgery may be necessary to correct the problem. The key is determining the right course of treatment for every patient. Fortunately, at My Houston Surgeons, we know that every patient is different, which is why we promote individualized approaches for every case.

CSF leaks are extremely dangerous and potentially life-threatening as they can lead to meningitis—an infection of the cerebrospinal fluid and lining that covers the brain. This is why it is important to consult a rhinologist immediately, if you suspect you are suffering from a CSF leak.

The Doctors at My Houston Surgeons have either authored or reviewed and approved this content. Page last updated:


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