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Treatment for CSF leak


#1

Hi there:

Are there any TCM treatments for a cranial CSF leak?

Had sinus surgery in 2010, and slowly developed double vision. Had surgery to correct that in 2015, however since then have had headaches, and a runny nose. As of three weeks ago, my doctor thinks its a CSF leak. Not wanting to go through the risky diagnostic tests, or suggested blood patch, I am trying bed rest to plug hole in dura. Headaches have abated, and my nose only runs when I lean forward. Not really dizzy, and can balance on one leg while I brush my teeth.

Getting MRI on March 9th, and seeing ENT on April 22nd.

Have a Chinese doctor in the city, however because of the winter weather/roads of late, I haven’t been able to ask her.

Thoughts?

Sincerely,

Karen Bergen


#2

Possibly. Certainly anything that can be healed by rest, can be aided by acupuncture. And some of the deeper issues, i.e. connective tissue disorders and/or other possible auto-immune/immune issues relationships do well with acupuncture.

That said, the diagnostic tests, as I understand them, wouldn’t be all that risky (just lab testing the drainage and imaging scans) - nor are the blood patch treatments in my opinion - should it come to that.

But under most circumstances I would be doing exactly what you are doing - trying rest, an anti-inflammatory diet, eliminating caffeine, etc. and try a few months of acupuncture along with that.


#3

Thank-you Chad for your encouraging e-mail. It has made me feel a bit more hopeful.

If I may ask one more question of you, why decrease coffee?

Most of the literature on this subject suggests increase caffeine consumption increases CSF. Although, I suppose if too much CSF, then too much pressure on dura tear. Is this the reason? In the past I’ve always tried decreasing my caffeine intake, however the past three weeks I’ve been increasing coffee. Definitely will decrease it again, and do as you say.

Thank-you kindly again for your advise. It’s much appreciated.

Sincerely,
Karen Bergen


#4

The caffeine is in fact listed both ways - but in this meta-analysis it says "Oral and intravenous administration of caffeine has been recommended as a therapeutic option for post-LP headache, often as an effort to avoid using the more invasive treatment of epidural blood patching. The presumed mechanism is thought to be increased cerebral arterial vasoconstriction, resulting in decreases in cerebral blood inflow and blood volume in the brain. No well-designed, adequately powered, randomized controlled studies have been performed to prove the effectiveness of caffeine. "

To me, it is best avoided due to the fight it creates between the effects of caffeine (vasoconstriction) and adenosine (vasodilation) - most importantly chronic consumption potentially leads to a tolerance towards adenisone. I think on average you want the body to be able to sort out exactly what it needs, not pushing it strongly one way or the other.


#5

Dear Chad:

Thank-you for your thoughtful, empirical response.

Lastly, if I could ask, what does this type of treatment does this type of issue require? I gather my practitioner would work on my governing vessel, as well as my usual issues (SP, KID), as I’m a 52 year old menopausal woman.

Regards,

Karen


#6

That would really be best addressed by your practitioner. There are far too many different approaches in Chinese Medicine to provide a useful answer. But, yes, generally, you are having as a primary focus your true diagnosis in Chinese Medicine terms (i.e. your deeper issues), then local systemic points likely be applied to reduce pressure, etc.


#7

Thank you so much for your time and thoughtfulness Chad.

Gold star bed side manner and promptness.:star2:

Appreciatively,

Karen Bergen


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