Spinal headache

A spinal headache or post-lumbar puncture headache occurs after undergoing a lumbar puncture and spinal anesthesia. Some individuals who have undergone these procedures ended up with a spinal headache. Remember that in these procedures, the membrane that surrounds the spinal cord and the sacral nerve root is punctured.

During a spinal tap or lumbar puncture, a small amount of cerebrospinal fluid is drawn out to be sent for analysis. In these procedures, if there is leakage of the spinal fluid, it can trigger a headache.

A spinal headache does not require treatment since it tends to settle. Nevertheless, if it lasts more than 24 hours, treatment is necessary.

What are the causes?

Spinal headache
A spinal headache occurs if the spinal fluid leaks via a puncture site in the membrane that surrounds the spinal cord.

A spinal headache occurs if the spinal fluid leaks via a puncture site in the membrane that surrounds the spinal cord. Due to the leakage, the pressure placed by the spinal fluid on the brain and spinal cord reduces which triggers a headache.

This type of headache typically occurs within 12-24 hours after a spinal anesthesia or spinal tap. In some instances, epidural anesthesia might also trigger a headache.

Indications of a spinal headache

  • Dull or throbbing pain
  • Pain can be mild or severe that can be debilitating
  • Dizziness
  • Pain is aggravated when sitting or standing and settles upon lying down
  • Nausea
  • Neck rigidity
  • Tinnitus
  • Light sensitivity

Management

When dealing with a spinal headache, conservative measures are initially used which includes bed rest, increased fluid intake, caffeine and pain medications. In case the headache could not be relieved and persists, the following measures are done:

  • Epidural blood patch – this is the initial line of treatment for persistent cases. During the procedure, a small amount of blood is injected into the space over the location of the puncture hole. This results to the formation of a clot that seals the hole, thus restoring normal pressure of the spinal fluid that relieves the headache.
  • Intravenous caffeine – caffeine works by alleviating a spinal headache by constricting the blood vessels. During the procedure, caffeine is released directly into the bloodstream to provide relief.
  • Epidural saline – saline or saltwater solution is injected into the space externally to the membrane covering the spinal cord. This places pressure on the site of the puncture and helps stop the leakage of the cerebrospinal fluid.

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