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If you or a loved one is affected by this condition, visit NORD Learn about Spontaneous Intracranial Hypotension, including symptoms, causes, and treatments. Myelography is the study of choice to identify the CSF leak but is not always necessary to make the diagnosis. The presence of Tau protein (2-transferrin) in nasal discharge establishes a diagnosis of CSF leak and a CT cisternogram identifies the site of the fistula. Spontaneous Intracranial Hypotension - Symptoms, Causes, Treatment NORD Learn about Spontaneous Intracranial Hypotension, including symptoms, causes, and treatments. Typical imaging findings consist of subdural fluid collections, pachymeningeal enhancement, pituitary hyperaemia and brain sagging, but magnetic resonance imaging may be normal. Associated symptoms are common and include neck pain, a change in hearing, diplopia, facial numbness, cognitive abnormalities and even coma. CSF Leak Causes Diagnosis Treatment Cerebrospinal fluid (CSF) rhinorrhea is different from a typical runny nose because it causes continuous dripping out of one nostril. Typically the headache is orthostatic in nature but other headache patterns occur as well. The term spontaneous leak is actually used to describe those not occurring due to iatrogenic effects of a medical procedure which can include those occurring. The underlying cause is a spontaneous spinal cerebrospinal fluid (CSF) leak. The triad of orthostatic headaches, diffuse pachymeningeal enhancement on head imaging and low CSF opening pressure is considered the hallmark of. This is a serious condition that can cause headaches. Practically all cases of spontaneous intracranial hypotension results from spontaneous cerebral spinal fluid (CSF) leaks, often at the level of the spine and only rarely from the skull base. Women are affected more commonly than men and most are in the fifth or sixth decade of life. Summary A CSF leak occurs when cerebrospinal fluid (CSF) escapes from the protective layer surrounding the brain and spinal cord. Spontaneous intracranial hypotension is an uncommon but not rare cause of new onset daily persistent headaches.