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Spinal Fluid Leaks - Dr Ian Carrol, Stanford

Discussion in 'General Treatment' started by ScottTriGuy, Mar 1, 2016.

  1. ScottTriGuy

    ScottTriGuy Stop the harm. Start the research and treatment.

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    Thanks to @Kati for pointing this video out - its 90 minutes and was well worth my time - bonus is the q and a when a doctor in the audience is humble!

    Here are my notes:

    Spinal Fluid Leaks



    Dr Ian Carrol, Stanford, ic38@stanford.edu

    Causes:

    1. hypermobility (coz durma weaker) (spontaneous)

    2. calcified bone pokes hole in durma (spontaneous)

    3. spinal tap / epidural / surgery (Post Dural Puncture)

    - 30 – 40% of spontaneous pts have multiple leaks


    Symptoms: headache, nausea, fatigue, neck pain / stiff, ridicular pain, neurological ‘weirdness’ (cognitive, memory, reading, etc), pituitary may be enlarged coz of CSF (Empty Sella Syndrome: may have low growth hormone; may hypothyroid) – also, feeling worse when standing, or later in the day: but relieved by laying down.

    Misdiagnosis: POTS, Chiari Formations, EDS, Tarlov Cysts, chronic migraine, CFS, FM, (maybe Parkinson’s, one case)

    Diagnosis:

    - often MRI deemed ‘normal’ (“by world class docs”), thus MRI not good diagnostic tool

    - CT myelogram will show abnormal

    - Elevated protein in CSF

    - 20% will have elevated prolactin (coz hypo-thalamus-pituitary-dissociation)

    Treatment:

    !st: EBP: Epidural Blood Patch (some require repeat after months, some so far so good)

    2nd: Fibrin ______________

    3rd: Surgery
     

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