BLaneMemberDecember 1, 2011 at 1:35 amPost count: 1
Hello, I am new to Colorado and am in search of an M.D., D.C. I live in the Broomfield area, and you are the only one I have found so far. I have had CSF leaks in the past, and am aware of all of the symptoms. I have had a horrendous cough in the past few weeks, but had no headache until yesterday afternoon. During a horrible coughing fit, my temples were pounding and I now have horrible pain through the temples, the back of my head, my neck and mid back. I do have some degeneration between the 5 and 6 vertebrate. My rib cage also tends to “pop out” of place (as per my last DC). I am concerned as to whether or not I have “sprung a leak” again because of the type of pain that I am now having. I was curious as to how long I should wait with the pain to get a lumbar puncture to check for pressure, or if there is another, less invasive test. I have had 2 Epidural blood patches to repair my leaks. The first took, and then broke loose after 2 weeks (I had had 5 weeks of a debilitating headache before I asked my MD/DC for a lumbar puncture) and he was shocked to see how low my fluid was and immediately got me in for the EBP. The second EBP was in the spring, and my headaches completely subsided… my neck and back pain has been minimal and I have had a “lightness” to me since.
I just know that I never want to feel that pain again. I still have the cough, and every time I cough, the pain radiates through my entire head. The pain is tolerable right now, but it just happened yesterday… last time I had one, it started this way as well, then slowly became debilitating, my vision changed, my face became weak on the left side, and I had numbness in my arms. It was as though I was “deflating”. I know that sometimes these can go away on their own, but in my case… I don’t think it will. I am a candidate for Ehler’s Dunlos Syndrome, but have not had the DNA profile done due to lack of insurance. I am, however, waiting for approval on Medicaid at this point. Pain medication is not helping this headache, which is one of my main “red flags” for a CSF leak. Please excuse my rambling, as I am under the weather, but could really use some advice as to where to go!! I figured that a DC/MD would be the best person to ask!
As a side note, I have had a CT and MRI in the past year, which noted a partially empty sella. During the last bout of headaches with no relief, I went through 2 chiropractic sessions per week (sometimes 3), trigger point injections, varying pain medications (which none of them worked) and the only thing that finally gave the relief was the EBP. Thank you so much for your time, if you need any further information, please ask! I look forward to your response!
In ChristDonald Corenman, MD, DCModeratorDecember 1, 2011 at 12:07 pmPost count: 8408
CSF (or cerebral spinal fluid) leaks normally occur after a direct injury to the dura. Something like spine surgery or spinal injection (epidurals or nerve blocks). I can tell you I have never seen a dural leak outside of a spinal intervention.
Coughing spells cause pressure change called a Valsalva maneuver. This increases pressure in the brain and spinal cord. Headaches after coughing spells would make me think more of small vessel irritation or even small ruptures in the cranium.
Epidural blood patches can reduce inflammation and not necessarily “cure” a spinal leak unless the leak was really present.
A true spinal leak should cause a headache that would increase with sitting up and be relieved with lying down.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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