I had my first ever Lumbar Puncture on Tuesday, under fluoroscopy, and all went well... Until about 6 hours later.
I started to develop a headache that peaked a few hours later. Worst headache of my life. The pain stops immediately upon lying down. There is no doubt that it's a spinal headache.
My questions are simple.
1. Is the hole truly leaking? Or is my body adjusting to the procedure [sudden volume change]? Yes, I know CSF replenishes fast but the jury seems to be out on this issue.
2. If it leaking, will it eventually heal on its own? Blood patches don't seem to heal anything, they just stop the leaking.
3. What are the chances of developing a subdural hematoma? This is rather scary and the reason I don't want to wait too long for a patch.
4. How long should I wait before getting a patch? I spoke to my neurologist earlier today and he said to have it done tomorrow if I'm not better. I called again tonight and spoke with the neurologist on call and she said it was indeed leaking and I should have it patched in the morning.
I know doctors are supposed to trump the Internet but in my opinion thy usually know less. Experience bests their knowledge many times. So, do I have a leak or not? Will my headache resolve on its own?
Right now, I am right at 50 hours post procedure. Right over 40 with a positional headache.
I have been as flat as a board since the procedure, save the hour commute to the hospital, which was done laying flat in a back seat. I've drank my caffeine and tons of fluid and just laid here mostly.
I'm like the average person, scared. Scared of what could happen if I don't get a blood patch and a little scared of complications of getting the blood patch itself. No shortage of horror stories on the blood path. No shortage of praise either. I don't have a cold or the flu but could and it could be transferred into my spine via the blood patch, this is one of my worries. Not to mention muscle pains people have spoken of.
I'm at an impasse here. I would appreciate any help anyone can give.
The blood patch will almost certainly make you feel worlds better and your discomfort, fear, ad headache will subside. If the patch doesn't work, they docs have several other things they do in a standard sort of order. The worst thing about all of this is actually the lumbar puncture itself. When people talk about it later, they talk about how bad it hurts when the needle goes in! You see, they forget about the headache. Sometimes it's good to know from the internet the ins and outs of physical problems, but I'll give you a tip: I have three fractured vertebra in my back, a fractured some other thing in my lumbar spine, periperphal neuropathy lifelong in my feet and hands that make them hurt a lot and also the muscles are kind of numbish so I'm clumsy and trip and drop things, I recently got over two of the worst kinds of cancer you can get but I lived, I've got a couple hernias in my gut where the bowel sticks out, I'm twice the weight I should be, I lost all my teeth... hmmmm, I think that's most of it... oh, yeah, Restless Legs, fun, fun, fun. Occasionally I'll look up a word or something, but all my docs learned real quick that I don't WANT to know what the hell is going on, just give me enough meicine (they NEVER do) and I'll be on my way.
I hope the blood patch does the job. And it's okay to move around a tad more than you are. Just mostly lay around and watch TV, read, get you a little snack and drink, use the phone... it's not like your spinal cord is going to paralyze you or your fluid is going to leak out all over the place.
1. It would be difficult to determine the precise cause of the headache without a detailed clinical evaluation, though a spinal headache would be the most common cause due mild change in pressure.
2. Yes mild leakage is expected to heal on its own.
3. It is very rare for a subdural haematoma to occur after an LP.
4. Though the blood patch can be done anytime after 24-48 hours, it is recommended to wait until a few days unless the headache is severe and not relieved by medications.
Hope this is helpful.
I would go for the blood patch if you are still symptomatic. When they work they are awesome! They most likely know where you are leaking due to the fact that you had a lumbar puncture.
I have had over a dozen and they are not usually painful. I have never had a sedative and it is a quick procedure. Remember, they are only putting the blood into the lining outside the dura mater, not into the arachnoid (subarachnoid)- this is the space that holds the cerebrospinal fluid.
I wouldn't read too much about it- just the basics- and don't read the things that went wrong for people. We will all have some things that don't go well, but trust your doctor and have it done with someone with lots of experience and knows the anatomy of your back!
Best to you and pray that you will soon be well. I am four and a half months with my present leak, but I have many spinal cord issues. I still have hope.
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