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Is Lumbar Drain Procedure Safe To Maintain CSF Flow Developed Post TBI ?

Posted on Fri, 27 Apr 2012

Question: My Son went through a TBI a month back , he had a brain surgery and after which his skull was closed. Now we have found he is having CSF Leaks and fluids are getting accumulated in his head. How can CSF leaks be repaired, how much time it takes for CSF leaks to get cured. Currently he is going through a Lumber Drain procedure to maintain the CSF flow. Is Lumbar drain the right way to cure this? Are there any medicine available to close CSF Leaks faster?

Answered by Dr. Praveen K Nath (25 hours later)

Hi XXXXXXX

Thanks for the query.

Sorry to know about your son.

I have gone through your son's history in detail.

Lumbar CSF drainage is considered to be the best procedure to deal with CSF leaks but we need to control infection with antibiotics, if there is any. You will know if any infection present through CSF culture and microscopy.

I would advise you to get a repeat CT scan of head to check for any raised Intracranial pressure, If present, we need to treat that simultaneously.

We generally give Osmotic diuretics to treat the raised Intracranial pressure which produces CSF leaks. Please discuss this with your treating doctor.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

Wishing your son a speedy recovery.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Praveen K Nath (10 hours later)

Dear Doctor,

How much it genrally takes for CSF leaks to repair with "Lumbar Drain" Procedure.
Also once the "Lumbar Drain" is removed is it possible that the CSF leaks starts again, then what will be the next step doctor should take.

In the long run are there are there any medicines which can strengthen the Dura Mater Layer so the Leaks don't start again.

I am bit worried on will the CSF leaks stop after "Lumbar Drain" and the tissues will get repaired or healed on there own?

Thanks
Rohit

Answered by Dr. Praveen K Nath (11 hours later)

Hi,
Thanks for the follow up.

There is no fixed time protocol for lumbar drainage .

Tendency is to remove it as early as possible to prevent infection.

It is very unlikely to recurr once it heals .

Depending on the cause of the leak, many cases go away on their own after a few days. Complete bed rest for several days is usually recommended.

Headache may be treated with pain relievers and fluids.

You will have to visit the doctor if:
You have a headache that gets worse when you sit up.
Thin, clear fluid draining from your nose or ear.

Repeat CT scans head are done to see rise of intracranial pressure etc.

Continue treatment as per your doctor .

Let us hope for the best.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Praveen K Nath (10 hours later)

Thanks!! Doctor..

I am pretty much satisfied with your answers but I am really worried if "Lumbar Drain" will really heal and seal the CSF Leak. I am also hoping that it seals in the next 2-3 days. My Son has already gone through it for 2.5 days now and we are seeing slight improvement. I am sure with time and next 2-3 days improvement will be much faster.

Please pass wishes to him that heals fast and leaks dont reoccur again.

Thanks!! once again.

Thanks and Regards
Rohit

Follow up: Dr. Praveen K Nath (10 hours later)

During a "Lumbar Drain" since its done at some gravity levels his drainge has stopped at current levels automatically, Is this the right or wrong indication. Though my child is not facing any pains or issues rigtht now.

Will the draininge start back automatically.

Regards
Rohit

Answered by Dr. Praveen K Nath (13 hours later)

Hi,

I am pleased to hear that my answer have been useful to you.

Lumbar drain should heal the csf leak.

It will be removed after about 1- 2 days of complete cessation of csf leak .

Get repeat ct scan whenever required

Wishing your son a speedy recovery

Regards

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Above answer was peer-reviewed by : Dr. Prasad