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Dr. Mark, Neurologist (MD)
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Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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My wife 51 yrs old has an inflamed dura and menges based on

Resolved Question:

My wife 51 yrs old has an inflamed dura and menges based on an MRI a spinal tap was performed with no signs of infection,leakage or menegitis
This all started after an epidural in her lower back due to numerous lumbar fusions L2-5 also cervical fusions
This has been going on for two months and no one has an answer she is currently in the hospital and we' ve been told to go to the Mayo clinic maybe they can help


Fiori Mangone XXX@XXXXXX.XXX
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Mark replied 1 year ago.
Hello.

What are her symptoms?

Does she have a headache which is worse when standing, and better when lying down?
Customer: replied 1 year ago.

Headaches are pretty constant A little better when laying down
Spinal tap is negative for any infections or leakage blood work all normal
Doctors suggest we go to the Mayo clinic they don't have an answer for us
Expert:  Dr. Mark replied 1 year ago.
And these headaches started only after the epidural injection in her lower back, correct?
Customer: replied 1 year ago.
Yes
Expert:  Dr. Mark replied 1 year ago.
OK.I am wondering if the "inflammed dura" seen on the MRI of the brain was more an issue with "intracranial hypotension", and a result of a potential spinal fluid leak in the lower back.When spinal fluid leaks, as can happen after a procedure such as an epidural injection, then people can have headaches, which are persistent, but clearly worse when standing upright, and better when lying flat.This can have the appearance of a meningitis on the MRI of the brain, and the fact that she then underwent a further spinal tap to rule out infections is good, but again could be contributing to a "spinal fluid headache".She may want to discuss the possibility of this with her doctors, and perhaps consider a "blood patch" procedure to try and plug up the "leak" in the spine -- if that is indeed what she has.
Customer: replied 1 year ago.
The pressures that were measured during the spinal tap were normal suggesting no leaks
Expert:  Dr. Mark replied 1 year ago.
Measuring pressure and getting a normal reading while she is lying flat may not tell you if there was a leak.A test called a myelogram can help to see if there are leaks, if this was a concern.Given the fact she does not have an infection, I would still consider a leak a possibility, especially because of the fact that her headache is worsened upright, and improved while lying flat.
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 11946
Experience: Neurosurgeon - Brain, spine, and peripheral nerve surgery
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