A Sigh of Relief....

We just got back from Dr Deshmukh's office and are feeling better than we were earlier.

Here's the deal with everything from today.

There is a Spinal Fluid Leak.

However, as of today the leak isn't bad at all.  If it was bad, it would be a stream of fluid coming out of her nose.  

At the office Dr Deshmukh tried to induce this by tilting her head down for 5 minutes.  Nothing.


We had a CT scan done at the hospital b/c CT scans are excellent for seeing fluids.  After
reviewing the scans himself and with his peer's they were relieved.  If there was a problem the
fluid would be seen in the skull just behind the ear.  The bone in that area has a lot of air pockets
in it (insert joke here for being an airhead!) and the pockets were still all looking great and no
fluid was present.  If the leak was bad then we'd see it in there for sure and there wouldn't be air
pockets.

Where is this fluid coming from?  

Red circle = ventricle, Blue circle = Hippocampus

It's coming from where we had to enter the water canal (water ventricle) during the 2nd surgery in order to remove the cavernoma that split off and hid behind the water ventricles tissue surface (i know, more coming on the 2nd surgery process tonight I promise).  They patched this with a sponge/foam plug; however fluid can still get out and once it passes through the tissue wall the pressure of the right temporal lobe will help keep it in place, after that the membrane that encapsulates the brain holds in fluid and finally your skull stops any fluid from leaching out.  In our scenario the fluid is following the path of least resistance and that happens to be the route that they went in for the surgery.  Once the brain heals though it will not drain anymore.


Is this fluid bad?  It is and it isn't.  The body produces around a pint of spinal fluid a day and it is used in the brain/spinal cord for a number of things --- it's very important and useful.  The brain absorbs this fluid normally so the fact that it's in the brain cavity is just fine.  It's only bad b/c if a fluid is finding it's way out of the brain and going into her nasal cavity and draining into the throat/nose then that means things can go into the brain --- specifically infections like meningitis....not good.  

How to we fix this?  If the leak stays the way it's leaking today then chances are the brain will heal itself via the scar tissue.  This however takes days/weeks to heal and it may not heal quickly enough.  If the leak starts to be more prevalent then we can fix it without doing an invasive brain surgery!  We can fix it via an outpatient method where they go in the same route they went for the surgery.  They go through the skin and the muscle in the jaw until they get to the bone around the back side of the ear.  Once they get to the bone they cover the bone with beeswax?!?!  This will seal the last line of defense (bone) for holding in fluids.  There is a small risk for infection however like with anything it's minimal.  This works very good b/c the bone is porous and not solid.  Liquid can slowly/surely work it's way through it and if we seal the outside of it then it can retain/hold it in where it belongs and block other bad things from getting in.

We can minimize the amount of fluid as well if we have her sit in between a 45 and 90 degree angle over the next few days until scar tissue can form over.  That means she is going to have to sleep in a recliner (we don't have one yet but I'm working on it).  Dr Deshmukh will call us in the morning to get a report on how things are going and if the fluid is draining out quickly or not.

So as of right now it's not as bad as we thought initially.  If it does increase, we can fix it without being too invasive.  There are still risks but minimal when compared to where we were last week.

Thx for the thoughts and prayers so much - it does help so much.  I'll try and put together a illustration on what Dr Deshmukh did on the 2nd surgery that they couldn't see/do the first time tonight.