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Neurology (Expert Forum)
Spinal headaches
Answered by
CCFNeuroMD JT, MD - Neurology/Epilepsy, Neurology/General
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 headaches
by MarkH4851, Oct 21, 2007 09:59AM
I had a discectomy performed on my L-5 six weeks ago and after the first 6 days, I had a CSF (spinal fluid) leak. I have been on my back for 34 days hoping the leak would heal itself. How long would it take to allow it to heal by itself before you would think about surgery to go in and repair the leak? And what would be the risk?
Doctor's Answer
by CCFNeuroMD JT, MD, Nov 06, 2007 08:16PM
, Nov 06, 2007 08:16PMTo: MarkH4851
I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist. Based on your history, persistent CSF leak is indeed of concern. Should this be the case, the symptoms you would likely be experiencing include what we call a "low-pressure headache"; that is, you should have a headache that is maximal in the upright position and nearly disappears upon laying down.
Have you discussed these symptoms with your neurosurgeon? Diagnosis of a CSF leak can be accomplished via imaging modalities such as a CT myelogram or magnetic resonance cisternography which can identify the actual location of the leak. If a persistent leak is evident, repair can be attempted by an epidural blood patch. Essentially, what this procedure entails is injection of your own blood into the epidural space at the level of the leak. The blood then clots and patches up the leak. Commonly encountered side effects are local pain at the injection site, infection, and recurrent CSF leak.
One month's time is sufficient to allow for spontaneous healing of the CSF leak and at this point, I would certainly contact your surgeon to inquire about the next step in your plan of care. I hope that I have answered some of your questions, and I wish you the best of luck in "patching" up your problem.
Have you discussed these symptoms with your neurosurgeon? Diagnosis of a CSF leak can be accomplished via imaging modalities such as a CT myelogram or magnetic resonance cisternography which can identify the actual location of the leak. If a persistent leak is evident, repair can be attempted by an epidural blood patch. Essentially, what this procedure entails is injection of your own blood into the epidural space at the level of the leak. The blood then clots and patches up the leak. Commonly encountered side effects are local pain at the injection site, infection, and recurrent CSF leak.
One month's time is sufficient to allow for spontaneous healing of the CSF leak and at this point, I would certainly contact your surgeon to inquire about the next step in your plan of care. I hope that I have answered some of your questions, and I wish you the best of luck in "patching" up your problem.
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