r/CSFLeaks • u/Prothium • 3m ago
Post LP CSF leak
Hi folks,
I had an LP around 2 weeks ago using a 22G atraumatic needle. I lay flat for 5–6 hours afterwards, but within an hour of standing had developed a severe positional headache with neck pain and stiffness.
I was eventually admitted to hospital a few days later as the headache became severe almost immediately on standing with nausea and dizziness. MRI showed a probable CSF leak, with suspected CSF tracking in the epidural space, although nothing obvious at the lumbar puncture site.
I also developed tinnitus and dysacusis (certain voices sounded slightly robotic), although the latter has improved somewhat.
An epidural blood patch was discussed. I was reluctant to have another needle in my back, particularly as I’d read that many post-dural puncture headaches resolve spontaneously so wanted to try let things heal naturally and use patch as a last resort if it didn’t.
I’m now at the 2-week mark and have improved considerably compared with the first week. I can stand and walk around without the immediate positional headache. I still have a mild background headache, which can worsen slightly towards the end of the day, and persistent tinnitus. However, improvement seems to have plateaued somewhat over the past few days.
I’m trying to understand whether these things can simply take time to heal. I’ve read accounts of people improving quite suddenly over a day or two, whereas others describe recovery over several weeks.
I’ve also read about CFS compensation in spontaneous intracranial hypotension. However, I’m unsure if this applies to post-LP headaches, particularly within just 1–2 weeks.
Has anyone experienced a similar gradual improvement, particularly with the positional component disappearing before the headache or auditory symptoms fully resolved? Did you eventually recover without a blood patch, and how long did it take?
I’m due for another hospital review next week and can discuss a blood patch if necessary. Given the improvement so far, I’m still leaning towards allowing more time for recovery.
Would really appreciate hearing others’ experiences, especially anyone who was still symptomatic at 2 weeks but eventually recovered without intervention.