Can a CSF leak be misdiagnosed?

Can a CSF leak be misdiagnosed?

Dr. Carroll believes that cerebrospinal fluid leaks are often misdiagnosed, and more common than previously thought.

What can CSF be mistaken for?

A spontaneous CSF leak and the clinical syndrome that it causes may be confused with a postdural puncture headache. With a postdural puncture headache, a patient usually has a single leak site in the dorsal dura. “There is up to a 90% response to a single epidural blood patch.

How do you confirm a CSF leak?

CT myelography. This test is considered the gold standard for diagnosing and locating CSF leaks. It uses a CT scan and a contrast dye to locate CSF leaks anywhere in the skull base. It provides the most precise location of a CSF leak and helps to determine the most appropriate treatment plan.

Does CSF test positive for glucose?

Normal levels of glucose in the CSF are greater than 50 mg/dL to 80 mg/dL, or 2.8 mmol/L to 4.4 mmol/L. If your levels are lower, you may have an infection. Your healthcare provider will look at your CSF glucose level along with the other CSF tests, and possibly other tests, to better understand what your results mean.

What can cause spontaneous CSF leak?

A CSF leak results from a hole or tear in the dura, the outermost layer of the meninges. Causes of the hole or tear can include head injury and brain or sinus surgery. CSF leaks may also occur after lumbar puncture, also called a spinal tap or spinal anesthesia.

What can cause a spontaneous CSF leak?

Can a sinus infection cause a CSF leak?

Cerebrospinal Fluid Leak Nasal CSF leaks are caused by small, sometimes microscopic breaks in the barrier between the brain and roof of the sinuses. The diagnosis can be difficult to make because nasal drainage is also caused by allergies, sinusitis, and other inflammatory conditions.

Can MRI Miss CSF leak?

In other words, the MRI must include specific sequences that are used to demonstrate CSF leak, making it easy to diagnose. If MRI with this specific CSF leak protocol is not deployed, a subtle leak may be missed, and, even sometimes, with an accurately performed MRI, some of the leaks cannot be diagnosed.

What color is a CSF leak?

The classic presentation of CSF leaks is the expression of clear, watery drainage from the nose. This occurs usually on one side; however if fluid drains into the back of the throat there may be a salty taste. Drainage also tends to increase when bending over or straining.

What does red blood cells in CSF indicate?

Red blood cell (RBC) count—normally no red blood cells are present in the CSF. The presence of red blood cells may indicate bleeding into the CSF or may indicate a “traumatic tap” – blood that leaked into the CSF sample during collection. White blood cell (WBC) count—normally very few white blood cells are present.

What does red blood cells in spinal fluid mean?

Finding red blood cells in the CSF may be a sign of bleeding. However, red blood cells in the CSF may also be due to the spinal tap needle hitting a blood vessel. Additional conditions which this test may help diagnose include: Arteriovenous malformation (cerebral) Cerebral aneurysm.

What is the most common cause of CSF leak?

A CSF leak results from a hole or tear in the dura, the outermost layer of the meninges. Causes of the hole or tear can include head injury and brain or sinus surgery. CSF leaks may also occur after lumbar puncture, also called a spinal tap or spinal anesthesia. Spontaneous CSF leaks can also occur for no known reason.

Can stress cause a CSF leak?

Spontaneous cerebrospinal fluid leak associated with cervical spondylosis could be induced by the repeated minor mechanical stress caused by physical exercise. Therefore, the possibility that non-postural persistent headache may be caused by spontaneous cerebrospinal fluid leak should not be underestimated.

Can CSF leak heal itself?

How is a cerebrospinal fluid leak treated? While many CSF leaks heal on their own and require only a period of bed rest, patients with symptoms of the condition should still visit their physician due to the increased risk of meningitis that is associated with cranial CSF leaks.

Can CSF leak without trauma?

CSF leakage in patients with no history of trauma or surgery is called spontaneous or nontraumatic CSF leakage. Spontaneous CSF leakage is rare, because most of the patients have some history of trauma, surgery, or a tumor that presented years before, but is often misdiagnosed.

What is a false positive VDRL CSF?

A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG.

Can a CSF-VDRL test be wrong?

A biological false positive CSF-VDRL test result for syphilis is rare. The CSF-VDRL syphilis test is not an appropriate screening test because, although specific, it is not sensitive. A negative result can also occur in some neurosyphilis patients, so the test cannot be used to rule out neurosyphilis.

What is the VDRL test for spinal fluid?

The VDRL on spinal fluid gives a high percentage of false negatives. The VDRL-CSF should be performed only when the patient’s SERUM treponemal test (FTA-ABS) result is reactive. Negative. Positive results will be titered. Collect cerebrospinal fluid (CSF) and freeze. Test sent to Mayo Medical Laboratories.

What are the limitations of CSF VDRL test for neurosyphilis?

Prozone phenomenon and biological false positive (BFP) reaction are two shortcomings of this test. Quantitative estimation of VDRL is essential in treatment evaluation. CSF VDRL test is very specific for neurosyphilis though its sensitivity is low.