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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Constant Head And Facial Pressure?

I am 3 months post microdiscectomy of the L5/S1 region. What was supposed to be a one day surgery lasted 7 days due to a really aggressive csf leak, that took two blood patches to correct. My neurosurgeon explained to be that I produce csf at a very fast rate and prescribed me acetazolamide to slow down production. About a month on those he took me off of them and at first I was fine. Then I noticed HAs about once a week. Now, as of July until the present I have horrible head pressure to the point of blurry vision. It is almost constant now, and I can t even sleep lying flat without my eyes feeling like they will pop out of my skull. I have spoke to him about this and he has decided to brush it off and has no answers. I have been to the ER twice and both times I was told just anxiety, given Ativan, and pushed out the door. Now my VA doc is wanting to put me on Zoloft for depression! I had a normal MRI/CT, however, I have not had a spinal tap. Other symptoms include tingling in my whole body with the head pressure goes up. I have completely lost my appetite. My concerns are that my csf flow is being obstructed or not reabsorbing correctly. I am no dummy when it comes to medicine. I was a combat medic in the Air Force for almost 7 years and almost finished with my nursing degree. Is there any insight you might have to this constant head and facial pressure? Thank you!
Tue, 14 Apr 2020
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General Surgeon 's  Response
Hello,

As per my surgical experience, the issue of constant headache with previous CSF leak indicate underlying issue of over production, under absorption or transport difficulties through arachnoid granulations and choroid plexus. Many cases do require a MRI with gadolinum contrast or ventriculograpy to delineate the fine tissue structures. Ventriculo-peritoneal shunt is also needed in many patients with constantly elevated intra-cranial pressures over a period of time.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Constant Head And Facial Pressure?

Hello, As per my surgical experience, the issue of constant headache with previous CSF leak indicate underlying issue of over production, under absorption or transport difficulties through arachnoid granulations and choroid plexus. Many cases do require a MRI with gadolinum contrast or ventriculograpy to delineate the fine tissue structures. Ventriculo-peritoneal shunt is also needed in many patients with constantly elevated intra-cranial pressures over a period of time. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon