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Spinal headaches

A spinal headache is a headache following a spinal procedure with needles, such as a lumbar puncture or spinal tap test, or epidural anaesthetic.

If the epidural needle accidentally passes through the dura containing spinal fluid, cerebro-spinal fluid (CSF) can leak out. A headache that develops after this problem is called a post dural puncture headache. When a headache occurs after a lumbar puncture it is the result of too much fluid leaking out of the small hole that was made in the dura during the procedure.

The risk of headache after an epidural or spinal anaesthetic is estimated to be between 1 in 100 and 1 in 500, and the headache may occur a day after or up to a week after the procedure.

What are the symptoms of a spinal headache?

The spinal headache often is described as "a headache like no other". Spinal headaches are much more severe when the person is in an upright position; they improve when the person lies down.

How are spinal headaches treated?

The first course of treatment for spinal headaches involves supplying adequate hydration to try to increase cerebral spinal fluid (CSF) pressure. Sometimes intravenous fluids (fluids administered into the veins) are given; other times the person is advised to drink a beverage high in caffeine. Strict bed rest for 24-48 hours is also recommended.

In addition, if a person develops a spinal headache following a procedure, the anaesthetist can create a blood patch with the person's blood to seal the leak. To administer a blood patch, the anaesthetist inserts a needle into the same space as, or right next to, the area in which the aesthetic was injected. The doctor then takes a small amount of blood from the patient and injects it into the epidural space. The blood clots and seals the hole that caused the leak.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on April 26, 2016

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