A spontaneous CSF<unk>  is termed so as it has previously been thought to be idiopathic, meaning the cause is unknown. The evidence of the last decade suggests however, that these<unk> s result from either a discogenic pathology, such as microspur, osteophyte or intra-dural disc herniation that pierces the dura like a knife, connective tissue disorder (which can often lead to discogenic pathology), or spinal drainage problems. A<unk>  can be a rare complication of an anterior cervical discectomy and fusion (ACDF). One study suggested a CSF<unk>  to follow from 0.5% of operations. Another study suggests a CSF<unk>  to follow from 1% of operations. In most of these cases repair is successful. Discogenic causes The most common cause of an intractable "sCSF"<unk>  is discogenic, either from an intra-dural disc herniation, osteophyte or microspur on the disc or vertebral body. "Recent radiological and microsurgical investigations revealed that a calcified, degenerative bony microspur is often the culprit lesion in cases of intractable CSF<unk> s. Arising from the level of the intervertebrate disk space, these microspurs pierce the ventral dura and produce a slit-like defect a few millimeters in length. These microspurs and the associated CSF<unk>  have to be localized exactly, and then they are amenable to surgical treatment." Connective tissue theory Various scientists and physicians have suggested that SCSFLs may be the result of an underlying connective tissue disorder affecting the spinal dura. It may also run in families and be associated with aortic aneurysms and joint hypermobility. Up to two thirds of those affected demonstrate some type of generalized connective tissue disorder. Marfan syndrome, Ehlers–Danlos syndrome, and autosomal dominant polycystic kidney disease are the three most common connective tissue disorders associated with SCSFLs. Roughly 20% of patients with a SCSFL exhibit features of Marfan syndrome, including tall stature, hollowed chest (pectus excavatum), joint hypermobility and arched palate. However, no other Marfan syndrome presentations are shown. Spinal drainage theory Some studies have proposed that issues with the spinal venous drainage system may cause a CSF<unk> . According to this theory, dural holes and intracranial hypotension are symptoms caused by low venous pressure in the epidural space. When inferior limb muscles pump blood towards the heart and pressure in the inferior vena cava vein becomes negative, the network of epidural veins is overdrained, causing CSF to be aspirated into the epidural space. True<unk> s can form at weak points in the spinal meninges. Therefore, the observed CSF hypotension is a result of CSF hypovolemia and reduced epidural venous pressure. Other causes Cranial CSF<unk> s result from intracranial hypertension in a vast majority of cases. The increased pressure causes a rupture of the cranial dura mater, leading to CSF<unk>  and intracranial hypotension. Patients with a nude nerve root, where the root sleeve is absent, are at increased risk for developing recurrent CSF<unk> s. Lumbar disc herniation has been reported to cause CSF<unk> s in at least one case. Degenerative spinal disc diseases cause a disc to pierce the dura mater, leading to a CSF<unk> .
Cerebrospinal fluid leak
Pneumocephalus
Brain herniation
Hemicrania continua
Hydrocephalus
Cerebrospinal fluid rhinorrhoea
Intraventricular hemorrhage
Epidural hematoma