Spontaneous Spinal Cerebrospinal Fluid Leak: Review and Management Algorithm.

Abstract Spontaneous spinal cerebrospinal fluid (CSF) leak is a condition which commonly presents with debilitating positional headaches. Often times, the etiology of the leak is located in the spine. While often cured with conservative management including epidural blood patching, a subset of patients will be refractory to this initial management. Determining the focal location of the spinal leak can, in some patients, require several imaging modalities. Treatment similarly involves multiple options including targeted epidural blood and/or fibrin patching as well as surgical closure. In this article, we review the current literature regarding this challenging condition and present an algorithm for management.