Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Neurology (Expert Forum)
Spinal Headache
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Spinal Headache
by honeybun369, Sep 11, 2009 08:34AM
I underwent surgery to repair a CSF leak that I had for two years in December 2008. It was caused by a tear in the dura due to surgery to fix a migrated lead (cervical area) of my Spinal Cord Stimulator. It was said I would get better but haven't. My headaches are better when laying, worse when upright. I had another myelogram done but my doctor said that it didn't show any more leakage. He said it might be positional. I don't have the SCS anymore - I had it removed. I also have RSD, Fibromyalgia, neck and back problems, dizziness, balance problems, etc. How can my symptoms stay the same but the diagnosis be different? Could there be another leak the myelogram didn't show? Any suggestions? Thanks.
Doctor's Answer
by Lama Chahine, MD, Sep 13, 2009 02:15PM
, Sep 13, 2009 02:15PM
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.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
As you mention, leakage of cerebrospinal fluid (the fluid that surrounds the brain and spine) leading to low pressure of CSF can cause headaches, and the headaches related to this classically improve when the person lies down and gets worse when the person sits or stands. The leak is most often detected by a CT myelogram, though in some cases a CT myelogram may not show an abnormality. In such cases, presumptive treatment for a leak (with a procedure called blood patch) could still be done if there is a high suspicion of such a leak. In other cases, treatment of the headache with typical medications that would include caffiene, NSAIDs, and IV hydration will usually allow the headache to resolve and the leak to resolve spontaneously with time. Continued follow-up with your physicians is recommended, with referral to a headache specialist (a neurologist specialized in headache disorders) for management of your symptoms if they persist.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
As you mention, leakage of cerebrospinal fluid (the fluid that surrounds the brain and spine) leading to low pressure of CSF can cause headaches, and the headaches related to this classically improve when the person lies down and gets worse when the person sits or stands. The leak is most often detected by a CT myelogram, though in some cases a CT myelogram may not show an abnormality. In such cases, presumptive treatment for a leak (with a procedure called blood patch) could still be done if there is a high suspicion of such a leak. In other cases, treatment of the headache with typical medications that would include caffiene, NSAIDs, and IV hydration will usually allow the headache to resolve and the leak to resolve spontaneously with time. Continued follow-up with your physicians is recommended, with referral to a headache specialist (a neurologist specialized in headache disorders) for management of your symptoms if they persist.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
