ER notes for chiari malf and vp shunt with sore throat and neck pain

[chrisking]

Just a few days ago I went to the er for a severe sore throat mild headache and very sore and stiff neck. I went to John hopkins memorial in bmore and they did a shunt study without contrast and a cat scan aalso blood work to test for infection. First the dr came in and said my test were fine, no shunt obstructions and the catscan lookd good. After 10 hrs in the er with no pain meds and nothing was said to me for hours I became frustrated. The team couldn't find anything wrong so they say and they wanted to do a lumbar puncture to test my fluid for menengitis. Knowing all along this was not the problem I denied the test for menengitis and sighned myself out. After 10 hrs of waiting and telling the drs I was going to leave they came in sat down and began telling me it was important to do the menengitis testing. Again I refused. The team then stated it showed on my Catscan that myleft lateral and third ventricles were slitlike. Also there is mild distention of the right lateral vent as well as mild prominence of the fourth vent. No evidence of intercranial hemorrage, acute ischemic event or extra-axial collections. The gray-white matter is well-preserved. There is no mass or midline shift. Basilare cisterns are patent. Mild to Moderate mucosal thickening and opacification of ethmoid sinuses.Surgical changes following suboccipital craniectomy for decompression of Chiari malformation.
My question to you all is, the dr had no results to compare these findings with so he stated this could be normal for you, I'm confused. It has been 12yrs since I had decompression for Chiari and vp placed after 5 revisions to shunt, still after 12 yrs I have not had any returning symptoms other than slight stress headaches which are very normal for me and this sore throat and stiff neck that has been bothering me for a week now. Usually my symptoms include double vision, ataxia, vertigo, vomiting and severe throbbing in one side of my head or another which I have had none of these since my last surgery which has been 12 yrs ago, so my question to you is again...Could someone with experience explain to me what this all means and if I should go back for a checkup or should I justleave it alone since everything seems to be alright and I am not having any real problems.....I do have a regular Dr apt on monday to check for sinus infection or cold and to test my sore throat.... thanks for your patients as always any advice please help....

[selmaS]

  Yes, it is time to have a check up and see if nething is going on...but, u would only get the spinal HA if u got up too quickly afterward...u need to lie flat and avoid lifting and bending for a time after....the fluid is replaced naturally and the tap should not leave u that off balanced....but I do understand...I had a spinal HA and they r not good...5 days in bed unable to move and eating while lying down....so I can relate to ur reasons.

Is the dr that treated  u orig still in practice?....can u see him/her for a check up?

  "selma"

[chrisking]

Thanks selma,
I really havent been around anyone who has been sick and I havent had any vomiting. No confussion well lol. anymore than nomal. No fevers either. I am honestly pretty scared to have them mess with the fluid in my brain if not necessary I haven't had any problems like I said in 12 yrs so I don't want to trigger any. Also if they were stating my fluid was low on the left ventricle, I was just under the impression that it would lower it more by doing a spinal tap. And that headache I really could do without lol. But yeah I have made an apt with my neurosurgeon which is all I've ever had and I haven't been followed by anyone since because I was told if I don't have any problems than I don't need to be seen. Guess its that time lol.

[selmaS]

  Hi Chris...I wish I had more info regarding shunts and how they could impact ur health in the long run...it is possible that u have scar tissue built up, but I am sure u would have diff symptoms if that were the case...

It's easy to mistake the early signs and symptoms of meningitis for the flu (influenza). Meningitis signs and symptoms may develop over several hours or over one or two days and, in anyone over the age of 2, typically include:

High fever
Severe headache that isn't easily confused with other types of headache
Stiff neck
Vomiting or nausea with headache
Confusion or difficulty concentrating — in the very young, this may appear as inability to maintain eye contact
Seizures
Sleepiness or difficulty waking up
Sensitivity to light
Lack of interest in drinking and eating
Skin rash in some cases, such as in viral or meningococcal meningitis

When to see a doctor
Seek medical care right away if you or someone in your family has signs or symptoms of meningitis, such as:

Fever
Severe, unrelenting headache
Confusion
Vomiting
Stiff neck
There's no way to know what kind of meningitis you or your child has without seeing your doctor and undergoing spinal fluid testing.

Viral meningitis may improve without treatment in a few days.
Bacterial meningitis is serious, can come on very quickly and requires prompt antibiotic treatment to improve the chances of a recovery without serious complications. Delaying treatment for bacterial meningitis increases the risk of permanent brain damage or death. In addition, bacterial meningitis can prove fatal in a matter of days.
Also talk to your doctor if a family member or someone you work with has meningitis. You may need to take medications to prevent getting sick.

May I ask y u r refusing the LP to rule out meningitis? AS long as the drs ar aware of the dx and draw slowly it should be ok...and if u still do not feel good about this, I would suggest a full check up by ur chiari dr.

Wish I could offer more

"selma"