Posttraumatic cerebrospinal fluid leak with cognitive dysfunction, especially visual memory disturbance: illustrative...

Area of Science:

• Neurology
• Neuropsychology

Background:

• Cerebrospinal fluid (CSF) leaks present diverse neurological symptoms.
• Cognitive dysfunction is a known manifestation, but its specific profile in CSF leaks requires further elucidation.

Purpose of the Study:

• To investigate the detailed cognitive profile associated with cerebrospinal fluid (CSF) leaks.
• To highlight visual memory impairment as a potential characteristic feature of CSF leaks.

Main Methods:

• Case study of a 17-year-old male with progressive cognitive decline post-head trauma.
• Neuropsychological testing revealed deficits in visual memory, working memory, and processing speed.
• Spinal MRI and CT myelography confirmed a cervical CSF leak, treated with an epidural blood patch.

Main Results:

• The patient experienced significant cognitive decline, including memory impairment and academic decline.
• Neuropsychological assessment identified specific deficits, notably in visual memory.
• Treatment with an epidural blood patch led to headache relief and cognitive improvement, especially in visual memory.

Conclusions:

• Cerebrospinal fluid (CSF) leaks can manifest primarily as cognitive dysfunction, potentially leading to misdiagnosis.
• Visual memory impairment may be an underrecognized hallmark of CSF leaks.
• Domain-specific neuropsychological assessment is vital for diagnosing atypical CSF leak presentations.