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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have dizzy spell after hitting head. Have had Chronic Spinal Stenosis and lumbar operations. Any idea?

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Dr. Krishna Kumar

Spine Surgeon

Practicing since :2002

Answered : 102 Questions

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Posted on Mon, 21 Jan 2013 in Brain and Spine
Question: Over a month ago, I had a bad reaction to a drug, and while I was in the kitchen, I passed out and hit my head on cupboard doors and split my head open and I my bladder let go. I do have Chronic Spinal Stenosis, have had to lumbar operations, and cervical. I was also told I may have Adhesive Arachnoiditis. Fibromyalgia, and Arthritis I did go to the emergency room and had a CT done, and 10 staples in my head, however, even after I had done all the right things, I have dizzy spells when I lay down...where my eyes are moving back and forth...should I be concerned?
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Answered by Dr. Krishna Kumar 7 hours later
Hello,
Thank you for your query.

I understand you had undergone multiple spine surgeries.

You had a CT in the emergency room, but you are still symptomatic. In these situations although your initial CT was normal, we would require a repeat CT to make sure that your brain is OK.

In some situation changes do occur after some time such as minor bleeding/clot etc.

So please go ahead and do a repeat CT.

Let me know if you have more concerns.

Thank you

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MRI OF LUMBOSACRAL SPINE: -

PROTOCOL:

-     SE T1W & TSE T2W SEQUENCES IN SAGITTAL PLANE.
-     TSE T2 W SEQUENCE IN AXIAL PLANE.
-     STIR SEQUENCE IN CORONAL PLANE.
-     MR MYELOGRAPHY USING HEAVILY T2W SEQUENCE IN SAGITTAL AND CORONAL PLANES ON A 1.5 TESLA SCANNER.

There is some degree of straightening of lumbar lordotic curvature. Vertebrae are normal in height, alignment and marrow signal intensity.
Dessicative disc changes and anterior osteophytes are noted at multiple levels. Disc height is reduced at L4-5 with degenerative endplate changes at this level.

There is diffuse disc bulge, thickened ligamentum flavum & facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R). The mid sagittal diameter and area of spinal canal are 0.8cm and 0.75cm² (lower normal limits are 1.0cm and 1.5cm² respectively. Effusion is detected in the facet joints.
Annular tear, diffuse disc bulge and facet joint arthropathy are visualized at L3-4 indenting the thecal sac.
Diffuse disc bulge is observed at L5-S1 mildly compromising the neural canals bilaterally.

Cord ends at L1 vertebral level and shows normal signal intensity. No abnormal pre or paraspinal soft tissue mass is seen. MR myelography confirms the above findings.

Impression      :     MR findings reveal lumbar spondylotic changes with
     -     Diffuse disc bulge, thickened ligamentum flavum and facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R).
     -     Annular tear, diffuse disc bulge and facet joint arthropathy at L3-4 indenting the thecal sac.
     -     Diffuse disc bulge at L5-S1 mildly compromising the neural canals bilaterally.

-     To be correlated clinically.

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