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Strong headache and nasal discharge with possibility of CSF leak

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In eed to speak to a neurologist now. I think i have csf leaks. I have migraines all day for three weeks. My nose runs. When i lay down pain is excruciating so i need sleeping pills. Have had it. Just fired my primary as he refused to send me to a neuro or get mri or spinal tap. I know its more than a migraine as i have six prescriptions for migraines and nothing works. Only percocet works for two hours. I want to know if these r leaks. Cant see my new primary til feb 3. Went to e.r. got a shot only lasted 24 hours and catscan as usual negative. I asked for mri and spinal tap but i was refused. Pls help. Thank you
Mary alexopoulos

Category: Neurologist, Medical

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Category: Pediatric Neurologist
 30 Doctors Online


Thank you for posting your query at

I have noted your symptoms and agree that based on the symptoms, we need to exclude a diagnosis of CSF leak (rhinorrhea). Confirmation of the diagnosis requires MRI brain with CSF flow studies. We can also send the nasal fluid for examination.

In patients with CSF leak, there is a higher risk of getting meningitis, so, the CSF should also be examined for infection, if CSF leak is confirmed on the MRI.

You need to consult a neurologist, as early as possible, so that a correct diagnosis can be arrived at.

I hope it helps. I would be glad to answer any follow-up queries.

Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

Patient replied :

Hi dr. Kumar

Thanks u so much for your help . You r the ONLY dr i know with a brain.

Just wanted to know if my problem that everytime i lay down the pain is a million tines worse and i have to take sleeping pills to knock me out. Is thus a symptom of a leak too cause i read it somewgers.

Thanks for all your help and i wish u were my dr.

Thank you for getting back.

Yes, CSF leak can lead to more headaches while lying down, however, in most people, this symptom may be absent.
Now it is important for you to keep an open approach not to be biased with any diagnosis.

The approach would be - I would suspect and rule out a CSF leak. But still I would strongly consider the possibility of a vascular headache. I request you to follow your Doctor recommendation (even though you are not really happy with it) and get back to the same Doctor. That way if the symptoms are persistent it will alert the Doctor for further tests. (since you review with the same Doctor)

Hope this helps
Thank you

Patient replied :

Hi dr.

Thank u for all your help. I cant see my new primary ti wed and he has to give orders for the tests and told me to go to his e.r. i went and i got steong percocets for seven days so i have enoufh til i see him these pills r really working til i get my tests. Thank u for everything u have done. U r the best

Dear Mary,

Thank you. Wish you good health

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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