Recently Answered Questions
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My doctor recommended another spinal surgery. Why?
Query: Hello doctor, I recently had two spinal surgeries for cauda equina syndrome. I was told that a second surgery was required due to a dural tear. However, on reading my clinical notes, I now question this. I have the operation notes, which I can send (about a paragraph each) if you have a spinal surge... Read Full »
Dr. J. Mariano Anto Bruno Mascarenhas
Answer: Hello, Welcome to icliniq.com. I have gone through your query with diligence and would like you to know that I am here to help you. Can you please elaborate on what your question is? Read Full »
After the blood patch, I developed swelling and a bump. Why?
Query: Hello doctor, I had a spinal tap done two weeks ago, and a blood patch three days later. The blood patch worked but, I still get headaches and do not feel well at all. I have a swollen bump on my tailbone that hurts. I saw my doctor who did not seem too sure about it but, said there did not seem to ... Read Full »
Answer: Hello,Welcome to icliniq.com.You most probably experienced a post dural puncture headache (PDPH), for which you were administered an epidural blood patch.Your signs and symptoms are more suggestive of a meningeal irritation due to some infection. I would suggest you consult a neurophysician for the... Read Full »
Can CSF leak cause opening pressure in sphenoid?
Query: Can someone interpret the two please? I am having pressure and metallic drainage after the second image could this be a CSF (Cerebrospinal fluid) leak? Also why does my pituitary look lifted/ detached? One is taken before a month and it shows my pituitary enlarged but looking intact, before I had a... Read Full »
Answer: Hi, Sorry for the pain you are going through. To find out CSF leak, investigation in cases like you is CT-cisternogram. ( spontaneous CSF leak has been reported in patients). You can sit in forward stupping ( bending forward) position, collect some fluid and send it for beta-transferin test ( speci... Read Full »
When will the headache due to CSF leakage subside?
Query: Hello doctor, My wife went to a routine check MRI (Magnetic Resonance Imaging) on the spine and found a lesion 14 x 12 mm, intraspinal, intradural focal lesion opposite L2 vertebral body with intense post-contrast enhancement suggestive of a neurogenic tumor. Doctors advised surgery, so we did surge... Read Full »
Answer: Hello, Welcome to icliniq.com. This is the usual plan in such type of cases. Headache is due to a leak of CSF (cerebrospinal fluid), causing low pressure in the head. The leak of CSF (Cerebrospinal Fluid) is a well-known risk factor associated with any intradural spinal surgery, so the doctor is not... Read Full »
I get watery discharge from my nose when I bend over to do something. Is it CSF leakage?
Query: Hello doctor, I am 32-year old and do not take any medications. I have had sinus issues, a runny nose, and sinus congestion for the past few weeks. The cough and chest congestion has subsided. For the last few days, I have had a watery discharge sometimes when I bend over to do something. I believe... Read Full »
Answer: Hello, Welcome to iclinq.com. I have read your query and understand your concern. Your complaints of watery discharge from the nose can be either due to allergic rhinitis or CSF leaks, as you rightly said. Both can be differentiated easily. Discharge due to allergic rhinitis is sometimes accompanied... Read Full »
I encountered a fall many years ago. Could that have caused a skull fracture?
Query: Hi doctor,I had a history of falls many years ago. Is it possible to fracture the skull when drunk and wake up the next day having no idea? Kindly help. Read Full »
Answer: Hi, Welcome to icliniq.com. I understand your concern and would explain that heavy drinking and brain trauma can cause memory loss. On the other hand, heavy drinking is a common cause of falling and head trauma. So, the answer to your question is yes. I hope you will find this information helpful... Read Full »
Which is a better treatment for NPH, shunt surgery or CSF drainage?
Query: Hello doctor, My 76 year old mother was recently diagnosed with normal pressure hydrocephalus. She is having trouble walking. She can walk only three to four steps at a time. She has been having this difficulty since a month now. She is currently not on any medication for this or for any other issue... Read Full »
Answer: Hello, Welcome to icliniq.com. I am sorry to hear about your mother. I have seen her MRI reports (attachment removed to protect patient identity). Going for lumbar puncture (LP) drainage, and then checking for a clinical improvement, before a shunt, has a better chance of determining the overall suc... Read Full »
Could you please explain MRI brain and CSF studies related to NPH?
Query: Hello doctor,Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies r... Read Full »
Answer: Hi, Welcome back to icliniq.com. The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if inco... Read Full »
Why is there a muscle tension in my shoulders, arms, and hands?
Query: Hello doctor, I have problems with clear thinking. When I am in a wrong position, there will be tension in my shoulders and arms, and in my face muscles, but also I cannot think clearly anymore. It is like a blackout. When I bend my head forward for a few seconds, my body reacts with sweating, rapid... Read Full »
Answer: Hello, Welcome to icliniq.com. I have gone through the attachments (attachments removed to protect patient identity). From your complaints, it looks like you are having tension type of pain. Actually, it occurs because of tensed tightened neck muscles. Some patients also feel similar pain in temple ... Read Full »
Why is there constant headache for over five years?
Query: Hello doctor, I have been suffering from a constant headache for over five years. An magnetic resonance imaging (MRI) done roughly 2 to 3 years ago showed pineal cysts but the report stated they were of no significance. Since then further investigations have been done to find the cause of my headach... Read Full »
Answer: Hello, Welcome to icliniq.com. I am fine. Through your case summary, you are suffering from persistent daily headache which is disabling your daily activities. You were completely evaluated for yourheadache initially where magnetic resonance venography (MRV) showed left transverse sinus stenosis 2 ... Read Full »