Spinal Headache

A spinal headache can occur after a person undergoes a lumbar puncture (spinal tap) or spinal anesthesia. Besides a dull or throbbing sensation, symptoms can include blurry vision, sensitivity to light, a spinning sensation (vertigo), and ringing in the ears (tinnitus). Since the headache pain occurs only when the person stands up, this type of headache can be cured by lying down until the headache runs its course.

What Is a Spinal Headache?

About one-fourth of the people who undergo a lumbar puncture (spinal tap) or spinal anesthesia develop a headache. These headaches are known as spinal headaches or spinal tap headaches. Many headache research scientists believe these headaches result from leakage of the spinal fluid (cerebrospinal fluid) that flows through pain-sensitive membranes around the brain and down to the spinal cord. The fluid, they suggest, drains through the tiny hole created by the spinal tap needle, causing the membranes to rub painfully against the bony skull.
 

What Are the Symptoms?

Spinal headache symptoms usually begin within 48 hours after a spinal tap or spinal anesthesia, but may be delayed up to 12 days. A spinal headache is often related to position, in that the head pain worsens with standing or sitting and improves with lying down. Coughing or shaking the head may also make the head pain worse. The longer the person is standing, the longer the spinal headache will remain after lying down.
 
A spinal headache can be dull or throbbing. It is often accompanied by nausea or a stiff neck. Occasionally, a person with a spinal headache will also complain of blurry vision, sensitivity to light, a spinning sensation (vertigo), and ringing in the ears (tinnitus).
 

Treatment for a Spinal Headache

Since headache pain occurs only when the person stands up, the "cure" is to remain lying down until the headache runs its course -- anywhere from a few hours to several days. Your healthcare provider may also recommend over-the-counter pain medicines (see Headache Medicines), as well as drinking plenty of fluids. Your healthcare provider may also recommend that you drink caffeinated fluids.
 
In some cases, your healthcare provider may give caffeine through an intravenous (IV) line. For those who do not respond to IV caffeine, an epidural blood patch may be recommended. An epidural blood patch involves injecting a small amount of your blood over the hole in the dura.
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