low pressure headache

my daughter of 15 years has been suffering from migrane (migraine) headaches for some mounths now and had a lumber puncure to get to the bottom of the problem,
she was told her csf pressure was to great so removed a small amount of fluid,
after 2 days she was readmited with a different headache of which we were told it was know a low pressure headache.
2 weeks in hospital passed and she had a blood patch which after 1 day she could stand up again (first time in 2 weeks) !
another day passed and her headache came back worse than before ,
she is now back in hospital but they dont seem to be able to sort it ,
overall its been 4 weeks of which she has spent this time lying in bed because the pain is so severe when she attemps to stand up,
could it be possible that a second patch is required and if so will she get back to normal afterwards ?
yours g baker.

[Nassim Abi Chahine, MD]

Hello, I need some clarification about the headache.
And did she got benefit from any medication or any medical act ?

[dethleffs]

Thank you for your reply.

Before my daughter had the lumbar puncture, she had a constant 'background' headache that she could control with paracetamol and ibuprofen, and migraine attacks that no medication prescribed seemed to touch. Doctors thought that these headaches might have been caused by high CSF fluid pressure, hence the reason for the lumbar puncture.

Since the lumbar puncture she has had more severe background headaches and an additional headache, which she describes as a sharp stabbing pain located near her right temple. These headaches seemed to be triggered by sitting/ standing up and relieved by lying completely flat. This headache is completely different to what she was experiencing before the lumbar puncture. Initially, doctors suggested this was a low CSF pressure headache due to too much CSF fluid being taken during the lumbar puncture.

The blood patch was done 3 weeks after the lumbar puncture and provided approximately 12 hours of relief, and enabled her to stand up without too much trauma.

Since the blood patch she seems to have deteriorated to the extent that lying flat now provides no relief from the pain. In the last 4 days (approx 4 weeks and 4 days after the lumbar puncture) she has been experiencing severe pain attacks, again affecting the right temple area, which can only be stopped by injecting morphine intravenously through a canular in her hand. These attacks have been allowed to continue for up to 50 minutes thus far although I am uncertain how long they would last if not interrupted by medical staff.

Other medications have been tried (although I'm unsure of their names) including drugs for 'cluster' headaches, migraines and relaxants. These pain attacks are so severe that she digs her nails into her forehead (drawing blood) and tries banging her head whilst she flails about in agony.

I should be extremely grateful for any thoughts or ideas about what my daughter is going through and any treatments that may be of use.

Kind regards,

G Baker

[Nassim Abi Chahine, MD]

Did she use Topiramate ? (Topamax)

[Nassim Abi Chahine, MD]

Topamax and other antiepileptic drugs can be very helpful when headache is a constant migraine type.
I want you to name all medications she tried.. we are going to form a personalized diet which will be very helpful.
Moreover I need you to take her blood pressure for three consecutive days. then give me the results