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Traumatic brain injury surgery and lumbar drain procedure cerebrospinal fluid leak accumulation above eyes recurring injury left center of the skull - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Head Injuries
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Hi Doctor thanks for your Time
Doctor :   HI
User :   I need to ask on some urgent questions as my Son is in very critical condition in a Hospital
User :   he has suffered with TBI (Traumatic Brain Injury) penetrating skull injury
User :   Its been now almost 1.5 Months he is hospital and has gone throw a surgery and Lumbar drain procedure
Doctor :   Ok Please go ahead
Doctor :   I am sorry to hear about this
User :   After the surgery "Csf Leak" happend from his dura mater tissues and it got accumulated on top of his eyes forming a lump
Doctor :   ok
User :   after "Lumbar Drain " was done the pressures got ok and even the lump was removed.. Lumbar drain happened for almost 4 days
User :   they removed the lumbar drain yesterday .. now its been 24 hrs and we seeing again the lump getting formed
User :   though with less pressures
User :   what should be done next
User :   shall we wait for csf leaks to get closed
User :   ?
Doctor :   CSF leaks which are small close by themselves
Doctor :   Otherwise a Surgical approach is taken
Doctor :   The treating Pediatric Surgeon and the Neurosurgeon should be able to inform you when would be the right time to intervene
User :   ok. But for now do you think there is still a chance leaks will go on there own .. I mean after leak started again with Lumbar drain
User :   is there still a chance they can close on there own after few days
User :   my child is just 5.5 yrs old
User :   in a child of this age does the repairing happen faster or it slower than normal youngster
Doctor :   That is a complex question
Doctor :   I want to know if there is a fistula that had formed at the site of the surgery
User :   yes might be that is the reason its leaking and accumulating in between the scal and skull above the eyes
User :   Though the actual site of injury is much above on left centre of the skull
Doctor :   Ok
User :   what can be done next doctor.. should we wait and watch.. Is surgery safe and successful
Doctor :   It is difficult to say how long to wait and what can this develop into
User :   yes but we are really worried
User :   yes right.
Doctor :   We just need to ask few questions if we go for surgery, are we doing a preemptive intervention before the CSF leaks stop by itself
User :   though our doctor has said we should wait for 2 days and then only he will suggest next step
User :   he said even if its leaking little bit now , ther could be a chance leaks hae started healing
User :   and may take 2 days to heal
Doctor :   Ok
Doctor :   What is the CSF pressure now
Doctor :   Is there less pressure
User :   its normal range
User :   I mean above 15 mm
User :   I am not to sure the measuring units
Doctor :   ok
User :   not yet
User :   he hasn't mentioned anything about the next step
User :   he is still positive on csf leak repair
Doctor :   Did the doctor say anything about epidural blood patch procedures
Doctor :   Ok
Doctor :   I should be less experienced than the neurosurgeon you are following up with, so I better suggest him to decide when to operate on
User :   ok thanks!! doctor will stay on his advice then
User :   but thanks for all your guidance
User :   i am really worried though
User :   bye
Doctor :   I understand sometimes time has the answers
Doctor :   So in your case too
Doctor :   I hope I have been of some help to you
Doctor :   Bye for now
User :   Hi
Doctor :   Hi
User :   who is this
Doctor :   Are y ou back?
User :   Hi Doctor. It seems I pressed the wrong link
User :   sorry
Doctor :   Ok
Doctor :   No problem
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