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What symptoms do you have?
Was this an intentional LP or an accidental dural puncture during an attempted epidural placement?
Sorry re delay - I was out of my office.
Do your symptoms vary with posture?
How soon after the LP did you get the pain ?
Having had a low pressure headache after a diagnostic LP myself you have my sympathy!
The duration of your symptoms is very unusual - the dura should have healed up long before now - also it is most unusual for a blood patch not to work - only if it has been placed at the wrong level would it fail.
This leaves only two options.
1.repeat the blood patch
2.treat conservatively with analgesics/laxatives and expect a spontaneous recovery
One study found that 87% of patients had recovered after 6 months.....
There are a few other treatments that have been tried such as iv caffeine , desmopressin but none have been validated.
Abdominal binders have also been used but are uncomfortable to wear.
Patients with long term symptoms are at risk of depression and it is important to be aware of this risk.
Please get back to me if you would like to chat some more.
Dear Dr Jef,
Thank you for your answer it was very helpful and after you wrote me I spoke to my doctor and he decided to perform another blood patch.
The blood patch was done this morning and I still have a very strong headache, even worse than before. does this meen the procedure did not work, or can it take some time till i feel better?
Hi, too early to say.
Often the patch gives an immediate result - however in a chronic case we need to be more patient for the volume of CSF to increase and for the pressure to return to normal.
I'll keep my fingers crossed for you.
I am glad.
I will keep my fingers crossed for you.
Hello Dr Jef,
I am feeling better, of from all narcotics but still feeling a little fuzzy. Do you think I Can say I'm on my way out of this mess?