Spinal Headache
Treatment
A spinal headache, also referred to as a post dural puncture headache (PDPH), occurs when cerebrospinal fluid is removed from the body. Cerebrospinal fluid helps cushion the brain. By removing some of the fluid the brain is not fully supported, leading to painful headaches. It takes six to eight hours for the spinal fluid to regenerate. However, if there is a leak at the site of the spinal tap (lumber puncture), the body will be playing catchup until the leak is closed. Several treatments exist for spinal headaches, including rest, hydration, medications and blood patches.
Symptoms
There are several symptoms of a spinal headache. These symptoms will also be present in other types of headaches, such as migraines. If you experience them within 24 to 48 hours after a spinal tap, then they are associated with a spinal headache.
Mild to severe headache is the hallmark symptom that a person experiences. The headache worsens when the person is upright (standing or sitting). The headache get better when lying down. Dizziness and nausea often occur with a spinal headache. A person's vision may also change, such as becoming blurry.
Blood Patch
A blood patch will often be performed when intervention is needed to treat a spinal headache. To perform a blood patch, a doctor needs to first draw blood from the patient. Then the blood is inserted around the area where the spinal tap occurred. The blood clots, which helps reduce or stop the leaking of spinal fluid. This allows the hole in the spinal cord to close without leaking spinal fluid.
A 2006 article by Dr. Robert Gaiser, published in Current Opinion in Anaesthesiology, reviewed the literature on spinal headaches. He found that 72 percent of these headaches resolved after 7 days without intervention. Doctors are often hesitant to perform blood patches because of the risk of infection. There is a risk of infection any time a spinal tap, epidural or blood patch is performed.
Unfortunately there are no strict guidelines as to when a blood patch should be administered. It is a doctor's personal preference. Some doctors will use a blood patch after 24 hours. Others will wait several days to a week before administering one.
Medication
Various medications can be prescribed to help with spinal headaches. Pain relievers are typically used. A doctor may tell a patient to use an over-the-counter pain medication, such as ibuprofen, acetominiphen or naproxen. Prescription pain relievers, such as narcotics, may be authorized by a doctor. Migraine medications, such as sumatriptan, can also be prescribed to help provide relief.
Rest
Laying down is one of the best things a person can do when suffering from a spinal headache. When in this position (supine) there is less pressure on the head, allowing the brain to be better supported. The overwhelming majority of doctors will have a patient use this as a first option for treatment. Most spinal headaches will clear up after 24 to 48 hours of bed rest.
Hydration
The body reproduces the cerebrospinal fluid it loses from a spinal tap. To properly do this, the body needs to be hydrated. Someone who is not properly hydrated can't reproduce the spinal fluid as easily, and thus the spinal headache may last longer. A combination of bed rest and drinking fluids, preferably water, can help aid the recovery process.
Tags: blood patch, spinal headache, spinal fluid, spinal headaches, with spinal, after hours
