CSF Leak Program



The University of Colorado CSF Leak Program specializes in the diagnosis and treatment of spontaneous intracranial hypotension (SIH). SIH is a headache disorder caused by leakage of cerebrospinal fluid (CSF) from the spine, and is characterized mainly by headache symptoms that are worse when upright and improved when lying flat. In addition to headache, patients also often describe a sense of pressure, ringing in their ears, changes in vision or hearing, dizziness, forgetfulness, or personality changes.

The understanding of SIH has greatly increased in the past decade. Once considered to be a diagnosis made only in individuals with an abnormal brain MRI, we are now understanding that patients may or may not present with an abnormal brain MRI but still have a spinal fluid leak. In addition, a type of leak called a CSF-venous fistula (CVF) was only discovered in 2014, and requires specialized testing called dynamic myelography in order to diagnose.

At the University of Colorado CSF Leak Program, our goal is to provide world-class, patient-centered, multidisciplinary care for patients who may be suffering from a spinal-fluid leak. Our clinic director, Dr. Andrew Callen, is a neuroradiologist who specializes in diagnosing and treating CSF leaks. He leads a collaborative team of radiologists, neurologists, and neurosurgeons to provide cutting-edge testing and treatment for this condition.

Andrew Callen, MD

Andrew Callen, MD, director of the CSF Leak Program



The images below show the three main types of cerebrospinal-fluid leaks that can cause spontaneous intracranial hypotension: dural defects, ruptured perineural cysts, and CSF venous fistulas.

Dural Defect
Ruptured Perineural Cyst
CSF Venous Fistula