CSF leaks can also happen spontaneously where a weak area in the dura just tears open. If after conservative treatment the patient is still symptomatic then an epidural blood patch will be needed to patch the area of damaged dura, preferably under fluoroscopy. The dura isn't well vascularised and so any time it's damaged, healing isn't always guaranteed which can lead to long term leaking and its disability. There needs to be more awareness about CSF leaks and their presentation as its really not known about. More doctors need to take an interest in the subject as I can only imagine that it will effect more and more people as time goes on.
