Spontaneous Cerebrospinal Fluid Leak - Research and Experimental Treatments

Research and Experimental Treatments

IV Cosyntropin, a corticosteroid that causes the brain to produce additional spinal fluid to replace the volume of the lost CSF and alleviate symptoms, has been used to treat CSF leaks.

In two small studies of two patients and another with one patient who suffered from recurrent CSF leaks where repeated blood patches failed to form clots and relieve symptoms, the patients received temporary but complete resolution of symptoms with an epidural saline infusion. The saline infusion temporarily restores the volume necessary for a patient to avoid SIH until the leak can be repaired properly. Intrathecal saline infusion is used in urgent cases such as intractable pain or decreased consciousness.

The gene TGFBR2 has been implicated in several connective tissue disorders including Marfan syndrome, arterial tortuosity and thoracic aortic aneurysm. A study of patients with SCSFLS demonstrated no mutations in this gene. Minor features of Marfan syndrome has been found in 20% of CSF leak patients. Abnormal findings of fibrillin-1 has been documented in these CSF leak patients but only one patient demonstrated a fibrillin-1 defect consistent with Marfan syndrome.

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