What are CSF Leaks?
The brain and spinal cord are surrounded by
a clear fluid called cerebral spinal fluid (CSF). This fluid
is under some pressure, which is higher at the base of the
spine than it is on the top of the head, due to a water column
effect. Enclosing the brain, spinal cord and CSF is a tough,
fibrous membrane called the dura mater. At the end of surgery,
the dura is sutured closed, in an attempt to make it watertight
and to prevent CSF from leaking. The leakage of CSF can create
a potential pathway for infection to get inside the brain
and spinal cord.
Surgeons often attempt to obtain a “water
tight” closure when suturing the dura, but the dura may dry
out during surgery and shrink, so that small gaps remain when
it is sutured closed. Also, needle holes produced during suturing
can leave small holes that may also leak. Despite meticulous
attempts to close the dura, many patients experience symptoms
resulting from CSF leakage after the surgery. These symptoms
can include delayed healing of surrounding tissues since CSF
is caustic to bone, muscle and skin. Collections of CSF under
the skin can cause compression of nerves and breakdown of
the wound closure. Low CSF levels can lead to severe headaches,
which are aggravated by sitting or standing up. CSF leaks
can also create a pathway to track bacteria and create life-threatening
complications, such as meningitis.
DuraSeal Dural Sealant has been developed
to assist the surgeon in obtaining a real watertight closure.
Following normal dura suturing, the surgeon can spray the
sealant onto the incision, effectively sealing all the needle
holes and other small gaps. The sealant then will stay in
place, sealing the incision while the incision heals naturally
underneath. Once dura healing is complete, DuraSeal then gets
softer, eventually becoming a liquid that is naturally absorbed
by the body.