Related Experiment Video
Updated: Nov 24, 2025
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Surgical intervention for spontaneous intracranial hypotension Type 4 CSF leak: A case report
Saba Shahab1, Mohamed A R Soliman2, Abdullah F Alkhamees3
1Department of Medicine and Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Background:
Spontaneous intracranial hypotension (SIH) is a rare condition that can be very debilitating. SIH is well understood to be due to a CSF leak, however, identifying the source of the leak is still a challenge. We are presenting a case of Type 4 CSF leak and reviewing the related literature.
Case Description:
A 46-year-old female presenting with intractable orthostatic headaches was diagnosed with SIH. She was unable to mobilize due to the severity of her symptoms. MRI scans of the brain and spine did not identify a source of the leak. After failing conservative therapy and multiple epidural blood patches, the patient underwent surgery which resulted in significant improvement in symptoms.
Conclusion:
This study has shown that surgical intervention improves symptoms in patients who do not have an identifiable source of CSF leak. Further studies need to be done to fully understand the role of surgery in Type 4 CSF leaks.
