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Neurology (Expert Forum)
meningitis?
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meningitis?
by bklk, Oct 22, 2004 12:00AM
Hello,
No headache history at all.
I had severe headaches since sept 1st that followed a sore throat etc. however no other symptoms during the headache.
Ct found sinusitis
Sept 11th.LP found elevated white cells (23)lymphocytes 90%
Continued headaches prompted sept 27th Lp showing 10 WBC and 87% lympnocytes protein now 60.
Headaches continue severe daily.
Tested for bacteria and viral cultures neg.
Lyme, W. Nile, HIV, Syphilis, etc. neg.
All routine blood work normal
MRI and repeat CT negative.
Repeat LP on 10/20 showed return to normal ranges for CSF but heaches contine
1. I read FLAIR sequence MRI is nearly the equal to contrast. Any benefit in contrast re-do?
2. could it be a CSF leak, the headaches are worse with motin/activity? How is this best tested for?
3. any suggestions to present to doctors? Can Viral meningitis last 6 weeks?
Thanks
No headache history at all.
I had severe headaches since sept 1st that followed a sore throat etc. however no other symptoms during the headache.
Ct found sinusitis
Sept 11th.LP found elevated white cells (23)lymphocytes 90%
Continued headaches prompted sept 27th Lp showing 10 WBC and 87% lympnocytes protein now 60.
Headaches continue severe daily.
Tested for bacteria and viral cultures neg.
Lyme, W. Nile, HIV, Syphilis, etc. neg.
All routine blood work normal
MRI and repeat CT negative.
Repeat LP on 10/20 showed return to normal ranges for CSF but heaches contine
1. I read FLAIR sequence MRI is nearly the equal to contrast. Any benefit in contrast re-do?
2. could it be a CSF leak, the headaches are worse with motin/activity? How is this best tested for?
3. any suggestions to present to doctors? Can Viral meningitis last 6 weeks?
Thanks
Doctor's Answer
by CCF-Neuro-M.D.-CS, Oct 22, 2004 12:00AM
The MRI probably should be done with and without contrast to look for enhancement. A contrast study differs from a FLAIR study, and provides different information. A CSF leak headache typically stops or decreases while lying flat, and increases with sitting or standing. If this sounds similar to your headache, you shold discuss this with your doctor. You may benefit from a "blood patch procedure" to stop the leak. This involves taking a vial of your blood and then placing it just outside of the spinal canal to help a clot form. Symptoms from viral meningitis can be quite prolonged. The other thing to ask your doctor about is a possible blockage in the venous system. This can be checked with a special MRI venous scan, and could cause persistent headaches. Good luck.
