Posted By CCF MD GS on March 13, 1998 at 16:34:29:
In Reply to: Re: Re: Spinal Pressure posted by CCF Forum Administrator on February 26, 1998 at 14:47:23:
: : : I have had 2 CAT scans and an MRI. The MRI showed enlarged vessels in my head and several venus pools.
: : The CAT scans came up negative. At first my doctor thought I had Psuedotumor Cerebri, but the second
: : spinal tap showed low pressure instead of high. This was when he had the second CAT scan done with a
: : die injection to look for a leak. He found nothing. He then admitted me to the hospital for DHE treatment
: : thinking once again I was having a migraine. Since we had tried 8 different medicines this seemed to be
: : the last resort. The DHE did nothing for my headache.
: : My history is three years ago I had a bone cyst removed from the right side of my skull. I was having
: : headaches and after numerous tested that showed nothing they took an x-ray which showed a large hole in my
: : skull. They biopsied the cysted and repaired the hole with some kind of plastic. The headaches continued
: : and for a long time I attributed the pain to recovery from the surgery. About 10 months ago the headaches
: : began to get much worse. Up to the point where now I can barely get out of bed without intense pain.
: : Due to the bizarre spinal pressure readings my doctor first treated me for low pressure which did not help.
: : He is now treating me for high pressure acetazolamide 500mg twice a day and duragesic patches for the pain.
: : The patches help a little but not much.
: : My first spinal tap the doctor tried 4 times but didn't think he got into the canal. Afterwards, I got a
: : spinal headache that lasted for 6 days.
: : The second spinal tap was a week later and showed a spinal pressure of zero.
: : The third spinal tap showed a spinal pressure of 8, then they added dye and did a CAT scan
: : to look for a leak. They found nothing.
: : The fourth spinal tap they wanted a reading both supine and upright. My supine
: : reading was 16 and upright (standing) was 57+ (the scale only went to 57)
: : The fifth spinal tap showed a supine pressure of 8 and a sitting pressure of 47.
: : My doctor said that the sitting pressure should have gone down not up. This
: : confused me because I would think the pressure would go up when sitting or standing.
: : Can you explain why a pressure reading should go down when sitting. Also,
: : would that be an indication that there is a clog or backup in my veins causing
: : the pressure to rise instead of fall.
: : I hope this gives you enough information.
please understand that some questions take longer than others to answer.
Also, our neurosurgeons are out of town for some continuing education. Your
question will be answered, however, if you need immediate medical attention,
you need to consult your local physician or emergency room.
I must say the story certainly is confusing and I'm not sure how much sense it makes to me. I'm not sure by what you mean regarding venous pools and enlarged vessels in your head? Are your doctors suggesting that you have some type of vascular malformation? Do you know if when they removed the bone cyst that the dura (covering of the brain) was invaded? You can develop spinal fluid leak if the dura is opened. Do you have any type of clear nasal discharge. When you saw you can not get out of bed does that mean that you are okay lying but upon getting up you have a bad headache that then goes away again with lying? If that is the case then it does sound like a low pressure headache and the treatment is either caffiene tablets or IV (I know it sounds strange) or a blood patch to close up the leak. Have they discussed this with you? The treatment with diamox should make you worse if you have a low pressure HA to begin with. We never move people from a lying to a sitting position with a needle in their back and the reading doesn't mean anything because you would have to pick a zero gravity point. The pressure should go up with sitting. Many things can affect the pressure reading including the inability to relax. I find the whole question / problem here confusing and would recommend another opinion. If you wish to see someone at CCF call 216 444 5559.
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