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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Trigeminal Neuralgia, Had 4 Surgeries, Reoccuring Lump At The Back Of Neck. Suggestions?

I have Trigeminal Neuralgia . I have had three surgeries...two included the insertion of a lumbar drain for 5 days...to seal a CSF leak from the dura of my brain. I had MVD surgery in December of 2010 and was left with the CSF leak A bulge formed in the back of my head near my neck . The first surgeon kept saying that it would heal on its own and the lump would go away by being reabsorbed into my body. After it just got larger and larger I consulted another NS and he said it would not heal on its own and he has performed 3 surgeries (2 of those also included him removing fat from my abdomen to help with the patch) and the last surgery was on Oct. 10, 2012. Well it s still leaking and the lump is back. It went down after the lumbar drain was in. Came home and it was pretty flat. Then it got large and I freaked. Then it went down again and now it s back again and pretty large. What should be my next step as I do not want to keep having unsuccessful surgeries. 4 brain surgeries in less than 24 months is enough.
Fri, 6 Dec 2013
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Anesthesiologist,  's  Response
hai I can understand ur agony having undergone so many procedures.But the two doctors are right in their own view as both the options have been described in neurosurgery standard text books.U had a csf leak after microvascular decompression which is a known complication of that surgery ndue to that u had swelling over the neck over posterior aspect.(pseudomeningocele).for this initially it su bsides with simple crepe bandage to head n asking the[patient to lie down in prone position.if it doesnt subside try to remove csf by keeping lumbaar drain.iF IT STILL DOESNT SUBSIDE THEN REEXPLORATION OF OPERATED SITE N CHECK FOR ANY LEAK PEPAIR BY PLACING A FAT GRAFT OR FASCIA LATA GRAFT.kiNDLY AGAIN CONSULT THE DOCTOR N IF DELAYED N IF CSF GETS INFECTED U WILL FACE SERIOUS PROBLEMS LIKE MENINGITIS.
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Have Trigeminal Neuralgia, Had 4 Surgeries, Reoccuring Lump At The Back Of Neck. Suggestions?

hai I can understand ur agony having undergone so many procedures.But the two doctors are right in their own view as both the options have been described in neurosurgery standard text books.U had a csf leak after microvascular decompression which is a known complication of that surgery ndue to that u had swelling over the neck over posterior aspect.(pseudomeningocele).for this initially it su bsides with simple crepe bandage to head n asking the[patient to lie down in prone position.if it doesnt subside try to remove csf by keeping lumbaar drain.iF IT STILL DOESNT SUBSIDE THEN REEXPLORATION OF OPERATED SITE N CHECK FOR ANY LEAK PEPAIR BY PLACING A FAT GRAFT OR FASCIA LATA GRAFT.kiNDLY AGAIN CONSULT THE DOCTOR N IF DELAYED N IF CSF GETS INFECTED U WILL FACE SERIOUS PROBLEMS LIKE MENINGITIS.