blood patch with acetazolamide?

[darpa6132002]

Hi all,

I'm a suspected leaker - (very mild) headache, blurry vision, light-headedness, all 100% positional and completely resolved when I lie down.

I've had 2 blood patches - one lumbar, one thoracic - that didn't do anything. My doctor wants to go ahead and try a third blood patch. I mentioned reading a paper in which the blood patch was performed after patients were pre-treated with acetazolamide, a drug that lowers CSF pressure. The idea was that high CSF pressure could make sealing a leak more difficult, and temporarily decreasing csf pressure with the drug would help the blood form a clot at the leak site. The paper reported a higher success rate than any other study I've seen (90% success after 1 patch, 100% success after 3 patches).

My doctor wasn't familiar with this study, though he said that he'd look into it. Has anyone had a blood patch with acetazolamide? Does anyone know if this practice is standard? I can't find many references to it besides the one paper.

Google blood patch with acetazolamide to find the paper

[punctured]

My doctor wasn't familiar with this study, though he said that he'd look into it. Has anyone had a blood patch with acetazolamide? Does anyone know if this practice is standard? I can't find many references to it besides the one paper.

I think you answered your question: it probably isn't standard. A more common thing do to I think is to install a lumbar drain, that's much more drastic of course and it means puncturing the system with risk of lumbar leak. It's done on purpose though to help cranial leaks heal. Back to the drug, I was put on acetazolamide just to see what would happen but I don't think I got a blood patch while on it. This drug is not super-pleasant, especially at the higher doses, I must say. I lasted perhaps a week or two on this...
P

[paradice15]

Hi everyone --- Anyone who can help me sort out this medical conundrum ???

I am back to this forum, after having been off for awhile. I really would appreciate input from my poor fellow sufferers!

My history is a dural puncture from a cervical epidural in 2008. Six blood patches, recent fibrin glue patch, all with no relief from the multiple daily crushing headaches. The last LP in March indicated "questionable" high CSF, and my diagnosis changed from low spinal fluid to high. I've been on over 30 different meds over these 4 1/2 years, including the acetazolamide and many others, which did not help and my stomach could not tolerate anyway.
As a background, I've never suffered headaches in my life, and these have put me on permanent disability. I get motion sickness easily, obviously limiting my formerly very active lifestyle!, and my only relief is lying down with a painkiller like Percocet or Fioricet. I can't imagine the havoc these drugs are wrecking on my liver, but I refuse to lie down and give in - I'm certain all of you feel the same way!

I've gone thru P/T, M/T, chiro, acupuncture, botox, Prolotherapy, Occipital nerve blocks, Median branch nerve blocks, and seen every "ologist" but a proctologist!! I've flown to Duke in NC to consult Dr. Gray twice, and come back in the same shape as prior to her interventions, despite her hard work to help me.

As Punctured indicated, the option left to me - other than a lifetime of pain meds - is a lumbar peritoneal shunt. My GP told me it's not a big deal, then my neuro told me to seriously consider before undergoing this extreme procedure! I'm ready to drill a hole in my own skull to relieve the pressure, so a shunt sounds very cool at this point.

Anyone have any feedback for me? I would greatly appreciate it!
Thank you ---
Marianne