CSF leak and Chiari 1

[kathy811]

Several months ago I had a CSF leak during lumbar surgery. The neurosurgeon could not even finish the disctectomy due to the large leak he had to repair because of the large amt of scar tissue he said he had to go through,  Spent 2 weeks in the hospital flat on my back. Went home for several days and had to return for emergency surgery to repair the leak again. Ten weeks later, severe headaches, severe eye pain, neck pain, and tingling all down my body,with also my R ear feeling full or plugged. Doctor sent me for a MRI brain scan and MRI of the lumbar. Results were no CSF leak found but now I have a Chiari Malformation (5mm). Did the CSF leak cause this?  I have not had these symptoms until I went through this horrible surgery. Is there a connection?

[selmaS]

oh my, well it is good u have the films....

was the injury from lifting or a fall...sorry, just curious.


keep  us posted on the next dr visit.

Godspeed
"selma"

[bdm92]

I had a low back injury which resulted in surgery, and also a cervical heniation which resulted in a fusion with plate and screws.
I think I do have both films, so I will take them to my next neuro visit.

bdm92

[selmaS]

if u have access to both MRI's it would be worth it to check...but get a chiari specialist to review the films......some NS and radiologists do not have the knowledge to evaluate this for u.

I believe it is possible u could have had chiari 0.....or a "mild chiari" and the puncture caused the resulting herniation.But only a chiari specialist can say, and then it's possible the first MRI isn't clear enuff to tell.

What kind of injury did u have?.....

Sorry u r going thru so much pain.

Godspeed
"selma"

[bdm92]

What do you think?  I had a myelogram in Aug 2007, it went bad, during the lumbar puncutre my spinal cord was hit and the procedure had to be stoped, but I wound up with the headache that lasted 3 days, my MRI that I had the same day as the lumbarpuncture showed some leakage.  
Now a year later I had an MRI of my brain due to all my symptoms and was told I have Chiari Mal, about 6mm.
I know that before the lumbar puncture I had an mri of the cervical region, would those films show the Chiari if it was there before?  If I can get the before lumbar puncture and after lumbar puncture mris of the cervical region would they be able to tell if I was born with it or if it was caused by the lumbar puncture?
This lumbar puncture was done due to a work injury, that has been an ongoing nightmare!

bdm92  

[Lovemygirls2]

I am not an expert on the connection between a lumbar puncture and Chiari, but I have read somewhere that a lumbar puncture can make a Chiari herniation worse.  Something about drawing out that spinal fluid and the pressure possibly making the herniation and symptoms worse.  I know this summer I had a lumber puncture to check the pressure.  My neurologist thought I had something called pseudo tumor cerebri.  My pressure ended up being normal, but I had a terrible spinal headache from a leak!  It was over 4th of July weekend so they couldn't get anyone in to give me a blood patch.  Luckily mine didn't last as long as yours did!  By Monday morning I was getting over the spinal headache.  BUT- where I am going with this....my Chiari symptoms worsened after the lumber puncture.  AND- the MRI I had done in May said I had a herniation of 5 mm, but when I had my surgery almost four weeks ago, my surgeon said the herniation had grown to 10mm.  SO- I am almost certain it was the lumber puncture that doubled my herniation.  I haven't had the opportunity to speak with my NS about it because I haven't had a follow up appointment yet from my surgery- but it will be something I ask him about.  I hope hearing my story might help a little.
Keep us posted and good luck

[selmaS]

sounds good...make sure ur dr is a specialist in chiari!
and join us in our social threads here on the forum!

Keep us posted!

Godspeed
"selma"

[kathy811]

No blood patch was done, but they removed some fat from my buttock after a silicone type patch did not seal the first time the leak was noticed during the lumbar surgery. so at that time I had to deal with another incision(3-4ins) on my buttock. That was not fun at all! I am seeing a neurologist in a couple of days. I will ask his opinion on the relation of the CSF leak to the Chiari.

[selmaS]

...ur NS should be able to tell u if it is congenital or aquired.

here is an article I saw on the web:



"Acquired" Chiari I malformation after multiple lumbar punctures: case report.Sathi S, Stieg PE.
Neurosurgical Service, Brigham and Women's Hospital, Children's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.

The authors present the history of a patient with a Chiari I malformation "acquired" after multiple traumatic lumbar punctures. The genesis of tonsillar descent is believed to be related to persistent leakage of cerebrospinal fluid secondary to the multiple traumatic lumbar punctures. The topic of acquired Chiari I malformations and complications of lumbar puncture is reviewed.

PMID: 8437671 [PubMed - indexed for MEDLINE]

do u know if they used a blood path to repair the leak?

Godspeed
"selma"