#Cerebrospinal fluid leak doctor in san francisco bay area skin

#Cerebrospinal fluid leak doctor in san francisco bay area skin

The CSF leak occurs when there is a tear or hole in the dura mater, the outermost layer of the meninges that protect the central nervous system, communicating the subarachnoid space with the epidural space and, sometimes, with the skin establishing a connexion between the CNS and the external environment. The CSF regulates CNS temperature, cushions the brain and spinal cord, and provides a delicately balanced buoyant force that allows the brain to retain its shape and circulatory integrity despite its weight and lack of intrinsic rigid support. The CSF also forms the blood-CSF barrier (BCSFB) circulation, acting in the removal of waste products and metabolites through its continuous renewal. This volume is defined by equal production and reabsorption rates of approximately 420 to 530 mL/day in adults. The volume of CSF is estimated at 125 mL to 150 mL in the SAS and 25 mL in the ventricular system. However, much controversy remains regarding the basic CSF physiology, which led some researchers to defy the conventional theory and propose alternative homeostatic mechanisms of CSF regulation. According to Cushing and Weed's seminal theory, the CSF is mainly produced by the choroid plexuses, a network of blood vessels and tissues located within the ventricles of the brain, and circulates throughout the CNS to be finally reabsorbed into the venous sinuses at the level of arachnoid granulation (AGs). It consists predominantly of 99% water, and 1% accounts for electrolytes, proteins, neurotransmitters, and glucose. This activity reviews the etiology, presentation, evaluation, and management of CSF leaks and reviews the role of the interprofessional team in evaluating, diagnosing, and managing the condition.Ĭerebrospinal fluid (CSF) is a clear, colorless liquid found in the subarachnoid space (SAS) that fills the neuroaxis cavities and surrounds the central nervous system (CNS).

Open communication of the subarachnoid space with CSF leak presents a pathway for life-threatening CNS infection, including meningitis. Additionally, the presence of a CSF leak indicates the need for further evaluation and management, as it may be due to a frontobasilar or temporal skull fracture. A leak in this system, therefore, can be detrimental to brain blood supply and function and can increase the risk of direct trauma to brain parenchyma due to loss of fluid cushion. CSF regulates central nervous system temperature, cushions the brain and spinal cord, and provides a delicately balanced buoyant force that allows the brain to retain its shape and circulatory integrity despite its weight and lack of intrinsic rigid support. It is found in the ventricles, surrounding the brain, and within the central spinal column. Cerebrospinal fluid (CSF) is a clear protein- and glucose-rich liquid in the subarachnoid space of the central nervous system.