Detecting the drip: pediatric neuroradiologist guide to spinal CSF leaks

Pediatric spinal CSF leaks are uncommon and encompass a spectrum of leak types with distinct imaging findings, diagnostic pathways, and treatment strategies. Brain and spine MRI guide the evaluation of suspected CSF leaks and the selection of advanced imaging techniques for precise leak localization. Leak types include dural tears, CSF-venous fistulas, and CSF-vascular malformation fistulas, each with distinct imaging and treatment considerations. This pictorial review illustrates the spectrum of pediatric spinal CSF leaks and provides a practical framework for their diagnosis and management.