When the spinal cord is punctured for a lumbar punch, epidural injection, or traumatic injury, leaking spinal fluid can leave you with a painful headache. Around 40% of people that go through some kind of spinal injection or test will experience this condition.
It usually begins with two days of the spinal procedure, but may take a little longer or occur sooner. Most cases aren’t serious, but your doctor will need to monitor the leak and act immediately if it doesn’t heal on its own.
Spinal headaches involve a throbbing yet dull pain that usually affects the whole head. The pain increases sharply when you change positions between sitting and standing up, but recedes while you lie down. You may also notice secondary symptoms like:
A spinal headache occurs when there is spinal fluid leakage from its normal area into the area around the brain which then changes the pressure to a great enough degree. At that point the patient may experience the onset of a spinal headache. There is a myriad of spinal anesthetic procedures which can cause this to happen, although it is now becoming less common due to the design of spinal needles improving a great deal in recent years. Procedures such as spinal taps and epidural blocks are what generally lead to a spinal headache, with the latter being more relevant now due to the fact that a larger needle is used during the placement of epidural anesthetics. It can take anywhere up to five days before symptoms begin to be felt in a patient who has had such a procedure.
For mild cases, bed rest and over-the-counter medications are prescribed, along with extra water and other fluids. Replenishing the body’s water supply helps it produce more spinal fluid to replace what’s missing. In more serious cases, an IV is used to give a more immediate source of fluids.
Drinking certain amounts of caffeine also boosts spinal fluid pressure when it’s getting too low. In cases that threaten spinal and brain health, your own blood is mixed with clotting agents and injected to create a natural bandage known as a blood patch. This treatment is available for people who regularly experience spinal headaches. For example, an anesthesiologist can apply a blood patch immediately after giving an epidural if they know it’s needed by the patient.
It is important that the design of needles and the steps of procedures continue to be improved so that there continues to be an ever reduced likelihood of this type of occurrence. Blood patches are one way that a doctor can seal the leak, which will prevent further agitation in the patient’s body. Adequate hydration before and after such procedures can help to maintain the proper amount of cerebral spinal fluid (CSF) and this might include the administration of intravenous fluids. Strict bed rest and the consumption of drinks high in caffeine will also help to a degree. If these more conservative approaches do not seem to be working as desired, then gabapentin, hydrocortisone, or theophylline have sometimes been prescribed for their known benefits. These are a prescription painkiller, steroid, and asthma drug respectively, which can all help in some cases.