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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Head injury, spinal fusion, replacement of discs, CSF leak, lumbar drainage. Treatment for constant headaches ?

Answered by
Dr. Shiva Kumar R


Practicing since :2001

Answered : 504 Questions

Posted on Tue, 2 Oct 2012 in Brain and Spine
Question: Hi:
In XXXXXXX 1998, 60.lbs. of steel fell 16ft. and hit me on the head. I wasn't knocked out but everything went grey and my vision closed in for a few seconds. It took about 3 mos. to clear the cobwebs and I found myself more than once at the back of the mill looking for my job. I had suspicions something wasn't right but didn't pay attention. In Dec. 2008 I had a C4-C5-C6 fusion done. They removed 2 discs, replaced them with metal cages used a rod and 3 screws with cadaver bone to hold everything in place. The sheath around the nerve bundle at I beleive C4 was perforated during the surgury. I was sent home the following day. A couple of days later my incision was swollen and leaking clear fluid. I went back to the hospital and was sent home. A couple of days later I went back and the neurosurgeon readmitted me as it was CSF I was leaking. They decided to do a lumbar drain to lower the level and let the glue used to repair the sheath do its thing. When they put in the needle the plastic fitting came loose and I leaked CSF into the bed for 10-15 mins. I got a pain at the base of my skull like I've never had before. At my 6mos. checkup my neck was starting to snap really loud, another MRI was done but everything was OK. That's when the headaches started. Now 2 1/2 yrs. later I live with the headaches daily, my right arm aches all the time and my right side of the face and neck constantly go to sleep. I've been told thats from scar tissue pressing on the nerve bundle where the leak started. What really bothers me is my thought process has changed. I have trouble forming the words into sentences in my head. It's like I choke on the words trying to get them out. I'm moody, irritable and prone to angry outbursts. My symptoms are getting worse not better. Am I right to focus on the CSF leak? Any thoughts or comments? Thanks for your time.
Answered by Dr. Shiva Kumar R 10 hours later

Thanks for posting your query. Your question is a very good one and I will try to provide you with information and recommendations regarding the symptoms you are experiencing.

Regarding the headaches that you are experiencing, I think this is most likely a Chronic Tension type headache. Though exact reason for these kind of headaches is not known, probably it is due to a heightened sensitivity to pain in certain people.

Potential triggers for headache include - Stress, Depression and anxiety, poor posture, Working in awkward positions or holding on in one position for a long time and jaw clenching.

A variety of medications are available to stop or reduce the pain. Tricyclic antidepressants like (amitriptyline) can be used to prevent headaches.

Regarding the pain in the right arm, I think it to be related to the injury to nerve which exits from the neck and supplies the right arm. This can be controlled with the use of amitriptyline again.

Regarding the numbness of right side of the face and neck, I again think it is due to the involvement of the cervical nerves which supply it and are probably injured due to the complications of the CSF leak. Most of the time they recover over a period of 6 months to 1 years without any intervention.

Regarding the CSF leak, I think it was a temporary problem after surgery and is no more a problem once it has stopped. It will not produce any added problems to you in the future.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your GP and get started on the medications for the headache.

I thank you again for the query and hope you find this reply to be helpful and informative. If you have any additional concerns I would be happy to address them.

Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Shiva Kumar R 23 hours later
Thanks for the comments. It fits my plan I've been forming for awhile now. I'm seeing my Dr. on Monday and will talk about something to releive the constant pain I'm in. It's hard to cope with day to day events when your constanly off balance. I'm going to start some counselling as soon as I can. (with a physcologist) Its been suggested I get a neuro/physc. evaluation, but it's very expensive and this long after the incident I don't know if it will help me. I try to be philosophical about whats happend to me.If I do have a MBI I have to learn to deal with the symptoms. I don't spend a lot of time on sites like these as I find some of the info kind of scary, but it helps to find out I'm not alone and not going crazy (I hope not!) I feel that the events that happened to me have accentuated the negatives in me so hopefully the counselling and pain meds will help. Thankyou XXXXXXX
Answered by Dr. Shiva Kumar R 6 hours later

Thanks for getting back to me again.

In addition to seeing a Neurologist and a Psychologist, you can even try meditation and yoga which can relieve your pain to some extent along with the medications.

So be positive as it can be brought under control and you will be able to lead a positive life.

I hope, I have answered your query.

Wish you good health.

Above answer was peer-reviewed by : Dr. Jyoti Patil

The User accepted the expert's answer

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