May 25, 2012
Topics A-Z Brain and Nervous System Fluid leak after a Spinal puncture
Fluid leak after a Spinal puncture |
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Dear Ask The Doctor: Hello, I had a spinal tap last sunday (9 days ago) and now i have the LP headache. It isn't that bad. I went to see a neurologist yesterday and he told me I have a CSF leak but wanted to see if it would heal on its own. He told me we can try medication to help it seal. He put me on meloxicam and tramadol. I am really confused why he would put me on the meloxicam because it is an anti- coagulation.... Also everything I am reading says NOT to take Non-Steroidal Anti-inflammatory meds for a CSF leak.. please explain.. thanks. Dear Eric: Headaches are the most common side effect of the lumbar puncture (15% to 50%), they occur because there is continued leakage of CSF, that cannot be replace soon enough causing a decrease in the intracranial pressure, which leads to traction on pain-sensitive structures. Usually is self limited, the management is symptomatic (rest and painkillers), but is persists the definitive treatment is done with the epidural blood patching technique which in general is safe and effective. Disabling headache after seven days of the procedure should be considered for an epidural blood patch. If after the headache persists after the epidural blood patch, it would be important to rule out other causes as: vein thrombosis, subdural haematoma, and meningitis, for example. Regarding the contraindications for Meloxicam these are as follows: Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. Meloxicam is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgeryNSAIDs cause an increased risk of serious gastrointestinal (GI) adverse reactions including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. |
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| Last Updated ( Thursday, 26 January 2012 ) |
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