CSF Leak

[CLL2008]

I had a spinal tap a year ago in the ER.  I suffer from migranes, could not get this one under control so they did a tap to rule out meningitis.  After the tap I lost hearing for about a week and suffered from a spinal tap headache. Since then my life has not been the same.  Constant pains in the neck and headaches ( different from my migraines), just recently I have these ice pick type pains in my head when I cough, sneeze , bend over or strain in any way.  I  have never had a blood patch. I was told that because I had previous back surgery around the L4-5 that I would be at greater risk for infection if I have the patch. I felt all along I was still leaking fluid but could never get anyone to help.
Very confused on what my next step should be.  Is it unsafe to leave CSF leaks untreated ? Do they sometimes just go away on their own ?  Are there any meds that you can take to help with this condition ?

Thanks

[CLL2008]

I had an MRI in February 2008 it was normal.  But... the NEW symptoms started after that MRI.  So you think I should have another MRI with dye to see if something has changed.

The doctor I saw a week or so ago said he thought it was a leak and prescribed the Gabapentin.  I felt the same as you that this was something that might treat the pain but not the problem.  I have never had a problem with sinusitis.  I have read stories from medical sites that people have had leaks for over a year.   If it is a leak is it dangerous if it goes undiagnosed ?

Thanks so much..


Its very hard to find a doctor in the Maryland area that knows about CSF leaks. Do you knwo anyone ?

[DrKalraMD]

Hi, it is unlikely to be CSF leak for such a long duration as leaks due to LP generally heal by itself. Kind of symptoms you are having seem not related to spinal tap procedure. What about your MRI report, did you have one?

Gabapentin is for neuropathic pain, it might help but before that one should establish the diagnosis. Your symptoms could be related to either raised intracranial pressure or simply sinusitis. Best will be to have MRI to rule out space occupying lesion.

Generally pain killers are given for these conditions

[CLL2008]

See my notes..its been over a year since the spinal tap and I am still having issues.  Have you heard that Gabapentin will stop the ice pick type pains that happen when I cough, sneeze etc. ?

Looking for answers on below question.
Is it unsafe to leave CSF leaks untreated ?
Do they sometimes just go away on their own ?  
Are there any meds that you can take to help with this condition

Thanks !

[DrKalraMD]

Hi, here is some quoted literature from website http://www.mayoclinic.com/health/spinal-headaches/DS00643/DSECTION=7

Treatment for spinal headaches begins conservatively. Your doctor may recommend bed rest and oral pain relievers. If your headache hasn't improved within 24 hours, your doctor may suggest one or more of the following treatments:

Epidural blood patch. Injecting a small amount of your blood into the space over the puncture hole will often form a clot to seal the hole, restoring normal pressure in the spinal fluid and relieving your headache.

Intravenous caffeine. Delivered directly into your bloodstream, caffeine helps relieve spinal headaches — usually within a few hours — by constricting blood vessels within your head.

Epidural saline. Injecting a saltwater solution into the space outside the membrane that covers your spinal cord may put pressure on the lumbar puncture site and stop the cerebrospinal fluid leak. But because saline solution is absorbed so quickly by the body, spinal headaches often recur after this treatment.

What about MRI brain report?