Spinal headache occurs in many patients who undergo spinal lumbar tap. It is a procedure mainly performed while giving spinal anesthesia. In this procedure a needle is inserted in the tough membrane of spinal canal which covers the spinal cord. Usually spinal tap is performed in lower lumbar and sacral spine.
While doing this procedure a small amount of spinal fluid leaks out, as a result there is change in cerebrospinal fluid pressure surrounding brain and spinal cord. When there is substantial loss of spinal fluid the pressure becomes too low in the skull leading to spinal headache.
Spinal headache typically occurs when the patient is standing and reduces soon after lying down. Most spinal headache resolves in one day after lumbar tapping, and no treatment is necessary. However, if it lasts for more than one day, patient may require medicines to relieve his headache.
What Causes A Spinal Headache?
Several causes have been attributed to cause spinal headache. In majority of patients it may occur as a minor complication after spinal tap or administration of spinal anesthesia. While performing a spinal tap, needle is inserted in the membrane covering the spinal cord.
Sometimes there is leakage from the hole after the procedure. Leakage of cerebrospinal fluid decreases pressure in the brain and spinal cord, which gives rise to spinal headache. Spinal headache usually occurs after 12 to 24 hours after spinal tap.
In some cases epidural anesthesia may also cause spinal headache, if the needle which is usually inserted outside the membrane accidentally touches and punctures the membrane.
Traumatic injury to spine or brain, surgery of spine or brain can also cause spinal headache if the cerebrospinal fluid leaks out from the injured area. The risk of suffering from spinal headache increases if the patient has previous history of spinal headache. It is more common in young patients undergoing the procedure.
Spinal Headache Symptoms
Most patients having spinal headache have history of spinal tap or spinal anesthesia. Headache usually begins 12 to 24 hours after the procedure. It may remain for a day and subside on its own. Sometimes it may prolong for few more days.
Spinal headache has unique feature, the headache is worse when patient gets up and stands, but as soon as he lies down the intensity becomes less. Spinal headache is often accompanied with other symptoms such as dizziness, nausea, stiffness in neck, typical abnormal sound in the ear and sensitivity to light.
The pain may radiate to neck and shoulder and there can be associated neck stiffness. The symptoms may worsen on coughing, straining, and sneezing and certain maneuvers. Spinal headache may resolve usually within few days.
How To Get Rid Of Headache After Spinal Tap?
If headache develops after spinal tap or after spinal anesthesia and has characteristic features of the condition, patient should be advised to lie down in supine position. Normally majority of spinal headache resolves within few days without any treatment. However, if the headache persists for a period of time or if it intense, patient may require analgesics and other symptomatic medicines.
Treatment is indicated in such cases to prevent complications such as subdural hematoma and seizures. Patient is advised to drink beverages which have caffeine. Intravenous fluids also increase hydration and help in increasing production of cerebrospinal fluid. In severe form where the leakage still persists, the anesthetist may inject a blood patch from patients own blood to seal the leakage. After injecting blood patient finds immediate relief from the symptom.