Spinal Headaches, Lumbar Puncture Headache, Prevention and Treatment

Each year almost a million people worldwide undergo lumbar puncture (or spinal tap) or spinal anaesthesia.

A lumbar puncture (also called LP) is a diagnostic procedure involving the extraction of cerebrospinal fluid (or CSF) by inserting a small needle into the membrane surrounding the spinal cord.

The leakage of spinal fluid causes lumbar puncture headache through the punctured site. The majority of headaches encountered in clinical practice are non-recurrent and occur as manifestations of systemic illness.

Approximately 30% of patients who undergo lumbar puncture experience headaches.

This headache typically lasts for a few hours and resolves without treatment; however, consult your primary healthcare provider for treatment if your headache persists after 24 hours.

Causes of Lumbar Puncture Headache

The lumbar puncture procedure is significantly valuable for diagnosing diseases and administering anesthesia. For example, a lumbar puncture procedure can treat epidural during childbirth.

The spinal cord is surrounded by a membrane known as the dura mater. During extraction of the cerebrospinal fluid (or CSF) for diagnosis, the needle punctures the dura meter, which is expected to seal up on its own.

The body replenishes its cerebrospinal fluid every 6-8 hours, so if the hole doesn’t heal up quickly, cerebrospinal fluid will leak out into the epidural space. This may cause the stretching of sensitive facial and ligament structures, resulting in dilation of the cerebral vessels and leading to the development of a headache helpful in

Other conditions resulting in the spinal fluid leak include a head injury (fractured skull) or a ruptured cyst.

Symptoms of Lumbar Puncture Headaches

The symptoms of spinal headache include:

  • Extreme pain and discomfort when you sit-up
  • Dull or throbbing pain that can be mild or incapacitating
  • Dizziness
  • Tinnitus (ringing in the ear)
  • Seizure
  • Sensitivity to light

Diagnosis

While post-lumbar puncture headaches are prominently obvious and rarely need a diagnosis test, your doctor may order an advanced imaging test such as a CT scan or an MRI to rule out other underlying conditions.

Management and Treatment

Mild cases of spinal headaches resolve on their own without treatment; however, if your headache persists for more than a few days, you should see a physician. The available treatment courses for treating spinal headaches include:

Hydration

Hydration helps facilitate extra cerebral spinal fluid (CSF) production. Your doctor may recommend intravenous fluid administration to increase cerebral spinal fluid (CSF) pressure.

Bed Rest

Your doctor may recommend bed rest for a few days to alleviate symptoms and create a situation where the hole may spontaneously close.

Caffeine

Caffeine may help validate solidated cerebral vessels and ease headaches.

Blood patch

Your doctor may use an epidural blood patch to seal up the hole. An epidural patch is created using a needle to take a small amount of blood from your skin and inject it into the epidural space. The blood forms a clot and seals the site of leakage.

Medication

Medication is often administered if all other procedures fail to treat a spinal headache. Your doctor may prescribe medication such as hydrocortisone or theophylline to ease discomfort.

Surgery

In rare cases, you may require surgery to seal up the leakage site. While recovering from a spinal headache, it is crucial to avoid strenuous activities for at least a week.

Risk factors

Specific factors that can increase the risk of lumbar puncture headache include:

  • Age ( young adult between the age of 18 and 30)
  • Pregnancy
  • Previous history of a severe headache
  • A small body mass

How to Prevent a Lumbar Puncture Headache

Your doctor can minimize the risk of causing a post-lumbar puncture headache by using a non-cutting needle for the procedure.

Conclusion

The complications of lumbar puncture include introducing infection into the meninges, severe headache, and sudden coning of the brain stem. A lumbar puncture is a hazardous procedure in the presence of intracranial tension.

When the lumbar subarachnoid space is obliterated, CSF can be obtained by cisternal puncture. If you experience extreme discomfort after a lumbar puncture procedure, seek immediate medical attention.