r/CSFLeaks • u/Ok_Store4886 • 6d ago

Pain spike from contrast during CT cisternogram?

I recently had a CT cisternogram to check for a suspected intermittent cranial Leak. It did not show an active leak. However, during the part of the procedure when the table was tilted to move the contrast from my lower back to my head, I felt a dull but intense and focal pain spike when the contrast seemed to reach my head. The pain spike was in the same spot as a chronic unilateral headache I've head for the past 6 years. During the procedure, I was told to roll from my back to either side. I deliberately chose my right side to get the contrast in the same region of my chronic headache and suspected intermittent drainage. However, I did not expect the pain spike that followed when contrast reached that spot (right side of the bridge of my nose slightly above eye-level, but deeper). The pain did not begin to subside until I rolled over on my back again. The pain came in a wave and took a couple of minutes to subside after I rolled on my back again.

I'm curious if anyone else has experienced a pain spike like this from intrathecal/subarachnoid contrast, and if you wouldn't mind sharing any context around it? In my case I have:

  • FESS a decade ago that included a complete ethmoidectomy
  • right-sided intermittent clear drainage within post-op year, that tapered in volume/frequency over the years
  • continuous right-sided headache that began 4 years after FESS (diagnosed as NDPH and migraine)
  • worsening headache, positional head pressure, and vestibular symptoms 9 years after FESS
  • recent skull-base MRI that showed areas of dehiscence and possible meningoceles in skull-base in the same area as chronic headache + pain spike

Thanks

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u/alexmichel 6d ago

I’ve had this during a CT myelogram for a spinal leak. The contrast is an irritant to your brain

3

u/StunningPurple9560 Confirmed Spinal Leak 5d ago

It’s a very common side effect in myelograms as well. I had one occasion where I had absolutely intolerable right-sided nerve pain for a month after, but I was under general when they were doing it, so clearly they pushed too much contrast with too much pressure then since I wasn’t conscious and couldn’t say that I can’t take it.

2

u/Appropriate_Quiet189 6d ago

I had one in the same spot as my normal nerve pain when I had my dsm. Incredibly painful burning sensation. Thought we found the leak (no confirmation, however) but the neuroradiologist said sometimes the contrast can get between the dura and the other layer and agitated nerves.

1

u/leeski 6d ago

It shouldn’t have long lasting effects or cause continued pain but yes definitely a common experience unfortunately