Headache post lumbar surgery

[xtcds1]

I'm 2 weeks out from a L5S1 laminotomy and foramenotomy. Did well for 72 hrs but then developed a severe postural headache, dizziness, tinnitus and hearing loss. Suspected problem was a dural leak. I tried bedrest for 5 days with no success so went back for a repeat CT which looked good - no CSF collection. Since I was so symptomatic I had an epidural blood patch which gave good relief for 36 hours but then I slowly got the symptoms back. The neurosurgeons and neurologists are reassuring me that these symptoms will slowly dissipate; I'm pessimistic. Here's my questions:

1. Anyone else had a dural leak managed conservatively?
2. How long did it take to feel better?
3. Would anyone try a 2nd epidural blood patch?

Thanks

[xtcds1]

Tinnitus is a multifactorial problem. Getting a bloodpatch just for tinnitus would be like taking out an appendix just because you have a fever. You need more signs, symptoms and imaging that point to an ongoing csf leak besides tinnitus.

[sudder]

PS:
Why do you think a patch just for tinnitus is unlikely to help?

[sudder]

So my tinnitus started 24 hr after a lumber puncture. I had severe neck pain and the roaring in my head but no headache. Got my first BP 1 month after, which didn´t help on tinnitus, but somehow still felt right, and relieved the neck pain a bit. 2 months after I still had tinnitus and needed to give it another try. Unfortunately, it seems like it didn´t resolve. Has been 3 days.
Whats brain fog?

[xtcds1]

My story from here is long and unresolved. Had the 2nd EBP and the headache/tinnitus were gone. 2 days later got new high pitch tinnitus and "brain fog". Long story short over the next 6 weeks developed a pseudomeningocele (bag of spinal fluid under skin). They watched it for a while but eventually reoperated after 2 months. Never found a leak at OR. Now I'm 2 months out from the 2nd OR and have the pseudomeningocele back! Symptoms (h/a, brian fog, tinnitus) are slowly improving despite increased lump size. Off to a major center now for re-evaluation and possible treatment.

In short I have a leak from somewhere after my surgery. Might be from the surgical area and was missed at re-operation or might be from the patches.

My advice: If you are post back surgery with a positional headache get some imaging and if positive for a leak a patch is an option. A patch just for tinnitus is unlikely to help unless there is documented evidence for a CSF leak. Check out this forum: lots of answers there:

www.braintalkcommunities.org

Also: talk with your doctors. Only they know you, the full story, your imaging and can give you any advice worth something. Never do anything based on something you find on the internet without full discussion with your doc.

[sudder]

Im trying my 2nd one today after 3 months with tinnitus. Doctors are very sceptic, im very scared, but here we go.

[Dr. A. Srivastava]

Hi, Thank you for your question. This kind of CSF leak and subsequent spinal headache after epidural are not common in general practices and may last for 24 hours or resolves without any treatment. But spinal headache chances are more in women and people with previous headache (migraine) history. Persistent headache could be a worrying concern and needs a complete evaluation with the neurologist. Doctor may suggest intravenous caffeine, epidural blood patch & epidural saline to provide you some relief from spinal headache. Another possibility could be worsening of Migraine symptoms due to stress, anxiety or surgical procedure. Avoidance of triggering factors would be helpful in fast recovery. Hope this information proves helpful. Take Care & Regards.