To prevent this rare complication, a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan is often performed before a lumbar puncture to look for any sign of a space-occupying lesion resulting in increased intracranial pressure. Increased pressure within the skull due to a brain tumor or other space-occupying lesion can lead to compression of the brainstem after a sample of cerebrospinal fluid is removed. Bleeding may occur near the puncture site or, rarely, in the epidural space. The pain might radiate down the back of your legs. You may feel pain or tenderness in your lower back after the procedure. Post-lumbar puncture headaches can last from a few hours to a week or more. The headaches are usually present when sitting or standing and resolve after lying down. The headache typically starts several hours up to two days after the procedure and may be accompanied by nausea, vomiting and dizziness. As many as 25% of people who undergo a lumbar puncture develop a headache afterward due to fluid leaking into nearby tissues. They are more than willing to answer all of your questions along the way.Although lumbar puncture (spinal tap) is generally recognized as safe, it does carry some risks. They make your treatment journey easier by guiding you through it step by step. Our patient navigators become your one-stop shop for scheduling appointments, coordinating your visits, communicating your test results, and planning surgery. Patient Navigators for Coordination of Care Their combined expertise ensures you experience a better outcome. Our team of sinus specialists, otologists, neurotologists, neuroradiologists, neurosurgeons, neurologists, neuro-ophthalmologists, and others work together to coordinate your treatment. Our advanced training, experience, and large number of cases contribute to our excellent results. This can optimize your surgeon's accuracy and help them avoid damage to surrounding tissue.ĭuke is one of the few centers in the country with the expertise to diagnose and treat CSF leaks that cause chronic headaches and other symptoms. The technique combines CT scans (which are ideal for displaying bony anatomy) and MRI scans (which are ideal for displaying softer tissues and fluids) and uses reference points to identify important neurological structures. You should begin to find relief from pain and other symptoms after seven to ten days.ĬT/MRI fusion is a navigation system, similar to a GPS, used during CSF leak surgery. You’ll be asked to return for follow-up visits one week after surgery and several more times at increasing intervals. This requires a longer hospital stay, usually three to seven days. You’ll need to stay in the hospital for three or four nights.įor leaks on the back of the skull (posterior) or that are difficult to access through the nose or behind the ear, surgeons may perform a traditional craniotomy, which requires a larger opening in the skull. This technique speeds recovery, leaves no visible scars, and requires only a couple of nights’ stay in the hospital.įor leaks on the side of the skull (lateral), surgeons may access and repair the leak through incisions behind the ear, which leave less visible scarring. Once surgeons reach the leak site, they repair the hole by plugging it with tissue or fat.įor leaks on the front of the skull (anterior), surgeons may access and repair the leak through the nostrils using a minimally invasive, endoscopic approach. Surgical approaches are tailored to the exact location of the leak. Surgery is often the best treatment option for cranial CSF leaks. Without treatment, CSF leaks can lead to loss of vision or other senses, hydrocephalus (a buildup of fluid in the cavities inside the brain), dangerous infections like meningitis, or death. The most common signs for cranial CSF leaks include chronic headaches and watery discharge from the nose or ear, especially on one side. Intracranial hypertension can be primary, meaning there is no certain cause, or secondary to another problem, such as a brain bleed. Too much CSF can wear down the skull, making it weak and prone to crack. Intracranial hypertension is similar to high blood pressure, but in the brain. This can be caused by a traumatic injury, tumor, infection, surgery, or intracranial hypertension. When an area of the skull is damaged, becomes thin, or cracks, the dura (the tissue that holds cerebrospinal fluid and surrounds the brain and spine) is exposed and can easily tear. Cerebrospinal fluid (CSF) is a watery fluid that protects, nourishes, and removes waste from the brain and spinal cord.
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