Do I have a CSF leak or possible Dural Tear?

i recently had back surgery double lumbar fusion L4,L5 L5,S1 about almost a month ago. I had complications during the surgery and lost 6liters of blood, Ive been experiencing mild to sever headaches usually when i stand for a amount of time or sit or even turn the wrong way, I have been placed on migraine medicine which does not work.The only thing that seems to have worked, is laying down for a long period of time. I have also been experiencing high blood pressure, since the surgery and also have rapid heart rate.I've been dealing with this ever since I was discharged from hospital. I returned to my surgeon and all he says, is that he does not know, and my symptoms are not a result of the surgery but refused to check to see if my complaints were valid.I have since visited my primary care doctor and she placed an order for a complete blood work up, Unfortunately, my next scheduled visit with the primary care physician is scheduled for a month out.I have been prescribed medication for migraines which does not help at all.I have been reading many articles on CSF leaks and many of the symptoms that are listed I have experienced.Symptoms such as, tingling and changes in hearing at times.My biggest fear however, is the headaches and  high blood pressure. I am only 26yrs old  and a non smoker. If anyone has any clue or could help ease my mind it would be great and if needed my blood pressure has reached as high as 159/103 and HR is usually around 115.


This discussion is related to Long term CSF leak causing progressive damage?.

[Dr Sharma]

Hi there. You could have possibly had a dural puncture during the two level lumbar fusions. CSF leak or post Dural puncture headache due to drag on the meninges from the leaking cerebrospinal fluid and displacement of intracranial structures. Bed rest and lying down flat from sitting or standing characteristically relief of symptoms. Adequate fluid resuscitation and NSAIDs when required. Epidural blood patch is tried if these measures fail to provide adequate relief. Check your basal blood pressure for a few days and consult your physician for antihypertensive drugs like beta-blockers and other supportive measures like salt restriction, weight reduction, adequate sleep and decreasing stress. Check out your hemoglobin levels for anemia. A detailed cardiac evaluation is required. Hope these help. Take care.

[prking]

i just came back from er and they said that they think it is also a csf leak or dural tear they said they couldnt do anything over there because of my cage that surrounds my L4,L5 the doctor tried to get in contact with my surgeon and was unsuccessful long story short the doctor wrote me something to give to my surgeon on what he thinks it is i have an appointment with my surgeons assistant friday. What i wanted to ask is what different ways could they go about taking care of this since i have a cage in the area that they would insert the blood clot? thank you very much for your advice  

[hemyinspain]

I had spinal surgury on slipped disc in my lower back in sept 07, a week later i had a severe fast csf leak, I was rehospitilised, operated on to fix leak, then suffered meningitis caught in theatre, then further severe leak.  Further surgery followed again to repair leak. 3 months later i was sent home where 2 days later I suffered the same symptoms although the liquid could not leave my body at this stage as the scar had healed and a large grapefruit fluid lump formed under the scar. From this date I have been trying to get a diagnosis. I absolutely believe I still have a slow csf leak. In July 08 I had a series of nuclear scans which after 48 hours showed displacement of the dye and leakage and unexplainably the dye around the brain did not move or disipate at all during the entire 72 hours of scans.  I have been under various neuros, Londons UCLH neuro department, Plymouth neuro and surgical departments, POTs testing, caffeine infusions, x rays, failed blood patch (failed due to inabiliity to get the needle through the scar tissue) ICP Bolt pressure monitoring etc. You name it, they have all done it. All inconclusive.  Now I am at the end of the road and the end of my tether. No one will do anything. I have seen a Dr specialising in Migraines in Harley street who agreed that there is no way I have migraines.  he gave me botox into my forehead above the eyebrows to numb a nerve that runs behind the eyes and I have to say that was incredible and almost completely stopped the pain behind my eyes for approximately 2 months.  But my headache from low neck and all the rest of my head was still there.
I have severe headaches each and every day. I wake up with a level 2/3 and by mid afternoon the pain is at an 8/9. I find long conversations very difficult, causing my headaches to increase, I cannot concentrate well, I have ringing in my ears sometimes and struggle to cope with loud noise, my balance is poor, pain behind my eyes unbearable and vision seriously affected. One eye drooping more and more on a weekly basis (although the botox did help that for a while)  Laying down eases my headache so long as I dont use too many pillows or tilt my head/neck too much. If I say on my tummy and arch up with my shoulders even a small amount my headache increases so rapidly! Also if I am stood up and I arch backwards a small amount the same happens.
I truly believe that i still have a leak or perhaps a movement of fluid blockage and I do not have migraines.  Can anyone please please help me or advise me what I can do now?  Where can I go?  Who can I turn to? Who will listen?  I lost my business and my home due to the original surgeries and am sueing the hospital in spain (Tarragona) where it was carried out but to be honest i would live in a tent if my head would stop.  I have been seriously depressed and even attempted suicide twice in the last 18 months however thanks to an amazing counsellor who has seen me for 4 hours every week for 15 months I am mentally and emotionally stronger and much more stable, i just cant cope with the pain.  Since all of this happened I now have a problem with my heart that no one knows what it is, inverted Twave apparently with skipping of beats and chest pain on any excersise, not that I can do any because of my head. It seems I am Sarah with no answers.  I cannot go on like this and need so desperately to get rid of my headaches even if only for 3 days a week.  I am so hoping someone here will have some advice that will help me finally get some answers.
Thank you for reading.
Sarah