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Thread: Spinal Fluid Leak ?????

  1. #1

    Spinal Fluid Leak ?????

    I have a few questions on a spinal fluid leak.

    Has anyone here ever experienced having such a leak?

    What were some of the symptoms, or side affects?

    Long term affect if not treated?

    Is it possible for a leak to seal itself?

  2. #2
    I am not sure exactly what you are asking ...

    The symptoms and issues with it are headache, and other neurologic changes.

    It is possible for the leak to seal itself. If that doesn't happen, I am not sure why you wouldn't get it repaired. You don't want that constant changing of pressure in the central nervous system.

    CKF

  3. #3
    I recently had two surgeries at the end of November, due to a Charcot at T11 & T12. Hardware installed to secure spine. I had tremendous headaches after the surgeries. After talking to the doctor, he said they could be from a possible spinal fluid leak. A MRI at that time would not really be able to spot the leak, due to so much blood and fluid from the surgeries. I went home, still having the headaches, but they were getting better. After a few weeks at home, I contacted the doctor and told him headaches were gone, just an occasional pain when I rolled over or sit up to quick.

    When I went in for my checkup, he had a MRI done. There was alot of fluid where he did the reconstruction and fusion. We discussed surgery, drain the fluid, and look for the leak. I really do not want another surgery. So, we decided to wait a couple of weeks to see if all the head pains would stop. Hopefully this would mean the leak sealed itself. I go next week to have a drain put in to remove the fluid. He said after we would be able to tell if there was still a leak after a few days, if it was still draining.

    I guess my questions are, if there is still a small leak, what are the risks? Are there major health risks involved? Could it have affects on other things? I mean its only now and then I have a head pain, it's not a headache. If I roll over quick, sit up quick, or sometimes when I do a weight shift, I will have a pain in my head that only lasts for a second or two. I can live with this if it means I don't have to go through another surgery.

  4. #4
    It depends on the size of the leak and how much it is pushing on the cord. If these are neglibile, I would probably wait a little longer.

    However, I would ask the surgeon what he/she thinks and what the complications are of not having the surgery done versus having it done.

    Be honest with him so that he can give you the correct information.

    CKF

  5. #5

    Spinal Fluid removed!!!

    I had a procedure done to remove the spinal fluid. When they were almost through with the procedure, I had a massive headache hit me, and they stopped the procedure. I couldn't move, lift my head, or anything without the the pain killing me. They contacted my doctor for him to come over and check things out. He said they removed about 250cc of fluid. They had warned me about a possible headache, but I didn't expect anything like that. I had to stay there almost 2 hours before I was able to get up.

    My doctor said this was an excessive amount of fluid, and we would have wait to see if the leak had sealed itself.

    It has been a couple of weeks now, and my wife said if feels like the fluid is returning. I really don't want to go through another surgery! Will it hurt anything to just leave the fluid in? Will the spinal fluid damage anything around it?

    My biggest concern is my doctor told me, the fluid is pooling where he did the fusion, and as long as this fluid is there, the fusion will not take. The level is T10 & T11. He also fused it in the front, and put in additional plates for securement. I am worried that if I don't get a fusion in the back, it maybe a week point. Will the rods, additional plates, and fusion in the front be enough to hold?

    I just don't know what to do?

  6. #6
    I will ask Dr Young to comment.

    AAD

  7. #7
    Junior Member allen54's Avatar
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    Spinal Fluid leak

    I had a spinal fluid leak and had one of the worst headache you can imagine.I was in the hospital for 4 days

  8. #8
    I would wait to see what Dr. Young says, but has a blood patch been suggested? It was my understanding that these are pretty simple to do and will seal any leaks.

  9. #9
    Quote Originally Posted by carman767
    I recently had two surgeries at the end of November, due to a Charcot at T11 & T12. Hardware installed to secure spine. I had tremendous headaches after the surgeries. After talking to the doctor, he said they could be from a possible spinal fluid leak. A MRI at that time would not really be able to spot the leak, due to so much blood and fluid from the surgeries. I went home, still having the headaches, but they were getting better. After a few weeks at home, I contacted the doctor and told him headaches were gone, just an occasional pain when I rolled over or sit up to quick.

    When I went in for my checkup, he had a MRI done. There was alot of fluid where he did the reconstruction and fusion. We discussed surgery, drain the fluid, and look for the leak. I really do not want another surgery. So, we decided to wait a couple of weeks to see if all the head pains would stop. Hopefully this would mean the leak sealed itself. I go next week to have a drain put in to remove the fluid. He said after we would be able to tell if there was still a leak after a few days, if it was still draining.

    I guess my questions are, if there is still a small leak, what are the risks? Are there major health risks involved? Could it have affects on other things? I mean its only now and then I have a head pain, it's not a headache. If I roll over quick, sit up quick, or sometimes when I do a weight shift, I will have a pain in my head that only lasts for a second or two. I can live with this if it means I don't have to go through another surgery.
    Carman, let me try to answer you with a general answer and then try to deal with your specific situation.

    Cerebrospinal fluid (CSF) leaks are something that all neurosurgeons fear and try hard to prevent. They occur when, often for reasons that are not well understood, the arachnoid and dura do not heal and CSF leaks out into the surrounding tissues, where it forms a cyst. If the cyst is in contact with the skin or mucosa, one can get continuous leakage of fluid. The brain makes about two liters (quarts) of CSF per day. About one liter goes down the spinal cord, in the space contaned by the arachnoid membrane. The arachnoid absorbs CSF and pushes it into the blood.

    As illustrated in the attached figure, two layers of membrane surround the spinal cord. One is called the arachnoid. Most of the CSF is between the spinal cord surface and the arachnoid (also called meninges). The dura mater surrounds the arachnoid. Normally, CSF fills the subarachnoid space and the arachnoid is up against the dura. However, if the arachnoid fails to close and there is leakage of CSF outside of the arachnoid, it may form a subdural cyst. Because the dura is tough and non-distensible, this is usually limited and eventually heals. However, if the dura is damaged and there is a dural opening, the CSF may leak into surrounding tissues where it may form an extradural cyst. Finally, if the extradural cyst is in communication with skin, there may be continuing leakage of CSF to the outside. The latter is risky because this means there is a direct conduit from the skin to the cerebrospinal fluid and bacteria may travel infect the meninges. Neurosurgeons are uncomfortable with this and will usually operate to close the leak.

    In your case, it sounds like there is no leak to the outside and that it may be forming either an intradural or extradural cyst. In such a case, most surgeons tend to treat the CSF conservatively and wait to see if it will close by itself. The CSF leak may result in a large fluctuant cyst that can be palpated under the skin. The surgeon may choose to operate on this. The main problem is that when one opens the cyst, most of the time, the leak is due to a tiny pinhole that cannot be see and it is ot possible to close it. As Ann (SCI-Nurse) pointed out, some surgeons do what is called a blood patch. They take some of your blood of clot and just place it over where they think the leak may be. Blood tends to be inflammatory and therefore will stimulate closure. Other surgeons use fibrin glue. CSF leaks usually will subside and seal themselves but it may take several weeks.

    Now, the question is why you get headaches with a CSF leak, particularly on spinal origins. As you know, you have spaces in your brain called ventricles that are CSF filled. When there is a CSF leak in arachnoid surrounding the spinal cord, this means that most of the CSF in the brain is draining downward. CSF is made by the choroid plexus, a vascular bed of arachnoid that is present in the fourth ventricle. If the choroid plexus is not making enough CSF to make up for the CSF that is lost by the leak, you may get headaches. The headache results, I believe from the ventricles collapse with a significant reduction in brain volume. This produces tension on the blood vessels that go to the dura and this the causes the headaches.

    Please note that the above is speculation on my part but this is the most plausible explanation of the headache, in my opinion. This is why when you lie down, especially with head lower than the spinal cord, the headache goes away. If the ventricles truly collapse, which sometimes happens when the cerebrospinal fluid is suddenly drained out and the tension of the blood vessels is great, it may cause some blood vessels to break. This is why children with ventricular drains for hydrocephalus may get an epidural hemorrhage when their drain takes out too much CSF. Tus, when you are having headaches, it is probably not a good idea to do a lot of sitting up and down, or suddenly getting up from a lying down position. The fact that your headaches are going away probably means that your leak is closing.

    I hope that this overlong explanation is not too confusing. Please do not hesitate to ask questions if anything that I say is not clear.

    Wise.

  10. #10
    I heard you can do a nasal fluid test, to check for csf. I am wondering if this is true and how accurate it would be.
    DIANA

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