• Noga Lipschitz, J Michael Hazenfield, Joseph T Breen, and Ravi N Samy.
• Department of Otolaryngology - Head and Neck Surgery.
• Curr Opin Otolaryngol Head Neck Surg. 2019 Oct 1; 27 (5): 339-343.

Purpose Of ReviewTo summarize the current evidence on the diagnostic evaluation of cranial cerebrospinal fluid (CSF) leaks and encephaloceles, including laboratory testing and imaging studies.Recent FindingsThe most sensitive and specific laboratory tests for CSF leak diagnosis are beta-2-transferrin and beta trace protein assays, the former more commonly used because of availability. Imaging studies used for localization of the leak site include high resolution computed tomography (HRCT) and magnetic resonance cisternography (MRC), often used in combination. Intrathecal contrast administration is reserved for complex cases with prior equivocal test results or for patients with multiple skull base defects to localize the leak site.SummaryDiagnosis of CSF leaks and encephaloceles is aimed at both confirming the leak and localizing the leak site. Future advancements in testing techniques may shorten the diagnostic process, limit the need for invasive testing, and improve the safety of such testing in indicated cases.

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