Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. Howevr I will try to provide you with some useful information.
When you say low pressure CSF, you are likely referring to intracranial hypotension. This is the decrease in the intracranial pressure caused by the decrease in the volume of the cerebrospinal fluid secondary to the CSF loss. CSF loss can occur via different mechanisms:
- operations/procedures involving a lumbar puncture
- Trauma which causes a CSF leak
- Neurosurgeries or ENT surgeries which can cause a break in the dura
- increased drainage from ventriculoperitoneal shunts (which might be the cause in your case, however I can’t be sure because I don’t know why the shunts were put in the first place)
- Spontaneous CSF leaks
The intracranial hypotension can produce symptoms like headache which worsens on standing up from a lying/sitting position, nausea, vomiting, vertigo, double vision etc.
The diagnosis is confirmed by a lumbar manometry (CSF pressure is directly checked with a spinal tap) and by the performed explorations (cerebral CT, cerebral MRI).
The intracranial hypotension treatment depend on the cause
- eg if there is a CSF leak in the spine, blood patches can be attempted
- if there is a CSF leak in the brain dura then surgery can be attempted to fix the leak
- if the ventriculoperitoneal shunt is draining a lot of fluid then the setting of the shunt can be adjusted
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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