Severe Headaches For Years, Dizziness, Cough, Pain In Neck. Spinal Fluid Low. What Is The Cause?

Posted on Wed, 8 Feb 2012

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 7 Feb 2012 Answered on

Wed, 27 Jun 2012 Last reviewed on

Question : I have had severe headaches for 3 years, and I eat excedrin like it's candy cause that's the only thing that makes them subside for a couple of hours (bottle of 100 in a week). I get dizzy and an intense throbbing headache when I bend over, cough, sneeze, have a BM, raise my voice, or when I am around loud music. I have pain in my neck, and my shoulders are tingly. I recently had an MRI and LP, but the only that showed up was that my spinal fluid was low. What could be causing these headaches. They are seriously impeeding on my life!

Answered by Dr. Sumit Bhatti (2 hours later)

Hi,

Thank you for your query.

1. Low CSF (Cerebro Spinal Fluid) pressure headaches usually subside on lying down. Does your headache increase on standing or sitting, or with exercise and decrease on lying down? Do you have a history of illness or head injury more than 3 years ago?

2. Normal CSF volume in an adult is about 150 ml and it is replaced about 5 times a day. Hence your problem may be due to decreased production, circulation, absorption or abnormal leakage from the skull or spinal cord.

3. Was your Lumbar Puncture a dry tap? Was the CSF pressure recorded? Was the CSF report Normal?

4. If a leak is suspected, a Cisternography may reveal the site of the leak.

5. It is good to hear that your MRI (Magnetic Resonant Imaging) is otherwise normal. This rules out many causes. If no leak is found, simple bed rest, hydration and increased caffeine intake may help raise the CSF pressure to normal levels.

6. If the Cisternography reveals the site of a leak / leaks, other treatment options are available. You may share the results of your Cisternography here for further discussion.

7. Excedrin contains caffeine; however large amount of intake may put you at risk of liver damage due to the paracetamol content.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sumit Bhatti (14 hours later)

Yes they are worse with increased movement, exercise, raising my voice, bending over, loud noise, bowel movements, coughing, yawning, sneezing, and so on. I am scheduled to have a c-spine MRI on Friday, will that show a leakage as well? My spinal fluid protein was 33, and glucose was 58. Lymphocytes-CSF was 80, Monocytes-CSF was 20 and RBC-CSF was 59. I don't understand what all that means. The sheet also says that tube #1-color was hazy, tube #3-color was clear.
Color spinal fluid tube #1-pink, and tube #3-colorless.

Answered by Dr. Sumit Bhatti (2 hours later)

Hi,

Thank you for writing back.

1. It will be helpful if you can share the MRI images and CSF report.

2. The MRI may show leakage or just meningeal enhancement at the site of a potential leak.

3.Your CSF report shows normal protein, glucose and WBC ratio. It is not clear if you are referring to the WBC ratio or individual counts. Normal WBC count in CSF is 3 to 5 / mm3. Presence of 59 RBCs /mm3 usually indicates a traumatic lumbar puncture, leading to a pink color. Normal CSF is colorless.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.

Above answer was peer-reviewed by : Dr. Yogesh D