Summary LEAK biobank 

Background

Normally, cerebrospinal fluid (CSF) is contained within the meninges and maintains a constant pressure of 8-18 cm water. The brain floats on the CSF, which also acts as a shock absorber for the brain during movements. Sometimes, a low pressure in the head occurs when CSF leaks into the spinal column. This causes the brain to sag slightly. Typical symptoms include positional headaches, which are significantly reduced or even absent when lying down but often unbearable when standing up. Other symptoms may include altered/reduced hearing, visual disturbances, cognitive impairments, gait disorders, and weakness in the arms.

In patients with CSF hypotension, an MRI of the brain can assess for signs of intracranial hypotension, and an MRI of the spinal column can locate the leak. Initial treatment often consists of a blood patch, which is effective in 50-70% of cases. If there is insufficient improvement, a dynamic myelography can be performed to find the exact location of the leak. Subsequently, consultation with neurosurgery can determine if the leak can be surgically closed. In the case of a CSF-venous fistula, endovascular treatment is sometimes possible.

Objective of the biobank

The LEAK biobank was established in 2025 with the aim of establishing a cohort study, which is to be used in future research on spontaneous intracranial hypotension. 
The symptoms associated with spontaneous intracranial hypotension manifest with great variance, which can hinder diagnosis. Diagnosis and treatment are complex and multidisciplinary, with close collaboration between neurology, neurosurgery, (neuro)interventional radiology, and anesthesiology. Several new diagnostic and therapeutic techniques have been introduced in the past years. This research will focus on improving the recognition of spontaneous intracranial hypotension, evaluating current diagnostics and treatments, and optimising the care pathway for patients with this condition. 

Does participating involve risks?

If the patient consents to a blood draw, a maximum of 30ml of blood will be drawn once for the LEAK biobank. All blood samples from the patient will, if possible, be taken simultaneously with scheduled blood draws as part of regular patient care. Furthermore, patients undergoing neurosurgical procedures to close leaks are asked for consent to take a meningeal biopsy during the procedure. This biopsy will only be performed if the surgeon deems it possible and safe to do so. There are no further risks associated with these studies.

Contact research team

Principal investigators: prof. dr. M.C. Brouwer (neuroloog)
Coördinators:                 drs. N.M.P.K. van Andel (physician-researcher)

Please feel free to contact us for questions or requests for collaboration per email.