POST SPINAL TAP HEADACHES

[TKRTX]

I just had a spinal tap on 7-15-08 as on out patient. I was sent home and was told to stay in bed for 24-48 hours on my back and then I could resume my normal routine. NO LIFTING WAS THE EXCEPTION. They did tell me to drink lots of fulds, but did not tell me to drink ALOT OF CAFFIENE as well. I guess this coffee stimulates the brain. I have had the most terrible headaches at the base of my head/spine area  when I stand or sit up ever since.

Mu doctor who is an Neurologist gave me some medicines for these types of headaches. They seem to take the edge off, but never go away.I have been in my bed or on my couch since Tuesday the 15, on my back, because it hurts too much to get up for any length of time.

Today is Sunday 07/20/08 and I  still have the headaches when I stand up or sit up. They are not as bad, but I think since I have had so much medicine that I have numb my senses to the pain.

My question to you is - Is the blood patching the best way to go for  a leaking tap? OR my doctor said something about maybe using CYRO to put back into the spine to help seal it as well. Have you heard of this procedure?

I can not feel any wetness at the site of the tap, can it be coming out somewheres else? Or does the body reabsorb it?

Please advise me on what  to do to get rid of these headaches..Help needed from TEXAS...

[mistyshea]

Hi my name is Misty and I also had a spinal tap just 4 weeks ago. I actually had to have another one 6 days after the first one. I also would get those horrible headaches that your talking about. No medicine would take it away. The only thing that helped mine was laying flat down on my back. I just wanted to let you know that mine slowly started easing like you said that yours is. Eventually it did go away without me doing anything for it. I would try to wait it out and see if it goes away on its own before doing anything. It took mine almost 3 weeks to go away. I know its extremely hard to wait it out with a headache like that. It was the worst headache I had ever had in my life.

[medchick0523]

I am so sorry you have a low-pressure headache, I've had four taps in the last couple of years and have gotten the headache all four times, my longest lasting nearly two weeks. The spinal fluid leaks internally from where the needle punctured the protective covering, and is just reabsorbed. I would say yes, the blood patch is the best way to go, it seals the hole and almost immediately you start feeling relief. If that's not a route you want to go, just keep up your fluid intake, caffiene stimulates the production of spinal fluid and increasing sodium intake helps retain fluid. I've never heard of the "CYRO" you mentioned. I hope you feel better soon!!

[TKRTX]

I am still having my headaches, but now instead of being at the base of my spine and head, they are back to the top of my head where they started.

I am still taking TIZANIDINE 4 MG (2 A BEDTIME), ESGIC- as needed for headaches, ZONISAMIDE 100 mg (2 a bedtime) , plus my morning coffee and I am also taking a good multi vitimins with minerals and and extra calcium. He gave me IMITREX , but it makes me queazy. None of the medicines that my doctor has given me seems to help.

I go back on 7/29/08 for the results of my Lumbar Puncture, lab results etc. My neurologist has done an MRI which showed 4 striations( spots) on the top of my brain. NO  tumors. He seems to think that I have MS or Lupus. I have NO family history of either one of these disorders.

I did go back to see him 2 days after the Lumber punture because of the severe headaches and he did tell me the some of the lab results had come back in. RA was negative, ANA 1:8 titer, ESR 8 mmhr and the glucose and protein from my spinal fluid all were good. The results of the MS Profile that he also had ordered, had not come back as of yet.  

My question to you is, just because my ANA had an titer of 1:8 does not always mean Lupus. It could be an inflammation in my body as well, right?  My doctor wants me to see an Rheumatologist because of the ANA.

I already have HASHAMOTO'S THYRIODITIS, (auto immune disorder) and my doctor told me that since I already had one auto immune disorder, that the possibility of getting another one like MS is greater. IS that correct?

I have 5-6 nodules in my thyriod now, but none of them are cancerous. My doctor that cares for me on my thyroid, has changed my medicine to Amour thyroid 2 gr a day. I have yearly scans on my thyroid to be sure that they are not growing and changing shape etc.

My concern is why am I still having the headaches, even after taking the medicine, my coffee intake, calcium etc?  I have noticed that if I eat anything with cheese in it, I throw it all up. Is this normal?

Tkrtx

[Neuro Forum]

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 your doctor.

When you undergo a lumbar puncture, as you know a needle is inserted into the space where there is cerebrospinal fluid (CSF) and the fluid is collected. The needle is withdrawn, and because it is a relatively small needle (though I know it does not feel small), it is expected that the small hole created by the needle seals off by itself. This is usually the case but rarely if spinal fluid leaks through the tiny puncture site, you may develop a headache, such as in your case. The hole is very small and the leak is in very small amounts and slow, so you will not feel the leak (you will not feel fluid leaking out of your back). The fluid leaks into surrounding tissue, but it is again in small amounts so there is not for example a collection of fluid in your back.

Besides causing a headache that is worse on standing, other symptoms can include dizziness, ringing in the ears, nausea, or vision changes.

Usually, for the few days after an LP, management is to keep hydrated, drink caffiene and use medications such as tylenol. IV caffiene can also be very helpful in some cases. If the headache persists after some time, such as in your case, the treatment can include an epidural blood patch, in which a small amount of your own blood is injected into the space where the puncture whole from the spinal needle was. This will form a clot to seal the hole, preventing further leakage.
I am not familiar with the term CRYO, but another treatment that has been used for post-LP headache in the past is epidural saline injection, when saltwater is injected into the space outside the area that contains the fluid, and it is thought that this puts some pressure on the leaking site, causing it to seal.

Thank you for providing me the opportunity to answer your questions, I hope you find this information useful, good luck.