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Does Intervertebral Disc Destruction With Spinal Cord Injury Cause Severe Headaches?

Posted on Mon, 9 Nov 2015

Question: My wife has a vertebrae pressing on her spinal cord anteriorly and fluid posteriorly, would this cause severe headaches constantly and is there anything to fix this?
Thanks

Answered by Dr. Neeraj Kumar (20 minutes later)

Brief Answer:
Provide more details regarding headache

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.

The MRI spine is showing intervertebral disc destruction with spinal cord injury (Probably hyper intensity due to myelitis or syrinx).

Headache may only occur if the cause of above lesion is somehow related to brain involvement also (e.g. tuberculous meningitis with hydrocephalous with arachnoiditis and syrinx or myelitis).
Headache at this age may be primary (commonly) or secondary.
What is the character, location, intensity, associated features of headache like nausea, vomiting, photophobia, sleep, anxiety, visual loss?

Is there any history of trauma, weakness of both lower limbs, urinary complains, tuberculosis, any malignancy?
Have you consulted a neurologist for workup? Provide all details.

Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Neeraj Kumar (34 minutes later)

She has a syringomelia and arachnoiditis. We went to a neurosurgeon and told us the fluid is normal. my concern is why is the fluid still there. is it possible the fluid is a csf leak? she does get nauseated. The headache never goes away. it stays at about a 3 then it will flair up to about a 7. would surgery help or any other options? Thanks

Answered by Dr. Neeraj Kumar (16 minutes later)

Brief Answer:
Require investigation in detail

Detailed Answer:
Hello,
It is necessary to get the diagnosis for proper treatment.
In such a case multiple investigations are required like Mri brain, VEP, csf study with Nmo antibodies, oligoclonal bands, antinuclear antibodies, tuberculosis, malignancy.
The csf diversion surgery may be done for spinal problems and lower limb weakness if advised by neurosurgeon but will not be helpful for headache.
I will advise you to consult a neurologist for proper evaluation, investigation and diagnosis.
For headache of primary nature you can give amitryptiline, sertraline for some time.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Neeraj Kumar (22 minutes later)

Last question, if it is a csf leak, wouldn't that cause headaches? Would cause air to rise and get into her skull.
Thanks

Answered by Dr. Neeraj Kumar (8 minutes later)

Brief Answer:
Visit a neurologist for diagnosis and work up

Detailed Answer:
Hello,
Csf leaking occurs due to trauma or post lumbar puncture.
Formation of syringomyelia is either secondary to leaking of csf into damaged cord parenchyma or due to pressure related csf diversion into cord parenchyma.
As this is usually a closed space so no question of air.
Headache in such case may be due to some diseases leading to involvement of brain as well as cord or causing raised intracranial pressure due to csf outflow obstruction.
Visit a neurologist with all reports for detailed assessment.

Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Neeraj Kumar (17 minutes later)

Thank you for your time and answers.

Answered by Dr. Neeraj Kumar (5 minutes later)

Brief Answer:
Thanks for your feedback

Detailed Answer:
Hello,
Welcome and thanks for your feedback.
Please do consult a neurologist for diagnosis for proper management.
Regards
Dr Neeraj Kumar
Neurologist
you can close the thread if all your questions answered with rating.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj