What is a spinal headache?
A spinal headache can occur as a result of a procedure such as a spinal tap (lumbar puncture) or epidural block (such as that performed during a woman’s labor and delivery).
During these procedures, a needle is placed within the fluid-filled space surrounding the spinal cord. This creates a passage for the spinal fluid to leak out, changing the fluid pressure of this space.
Because the design of spinal needles has been improved, spinal headaches after a spinal tap or administration of spinal anesthesia are rare. When epidural anesthetics are placed with a larger needle than that used for spinal anesthetics, however, the likelihood of headache is higher if the epidural needle should inadvertently pass through the dura matter (covering of the spinal cord).
A spinal headache might occur up to five days after the procedure is performed. Such a headache might be prevented with bed rest after a procedure.
What causes a spinal headache?
Spinal headaches are caused by a decrease in the pressure exerted by the cerebral spinal fluid (CSF) around the patient’s brain and spinal cord. When a needle passes through the dura mater (the tough covering of the spinal cord and brain), it creates a passage for spinal fluid to leak out. If enough of the fluid leaks out, the patient might experience a spinal headache.
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 patient is in an upright position. They improve when the patient 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 the patient can be hydrated with intravenous fluids (fluids administered into the veins) or by drinking a beverage that is high in caffeine. Caffeine makes blood vessels get smaller, helping increase CSF pressure.
Another treatment might be strict bed rest for 24 to 48 hours.
If a patient develops a severe headache, the anesthesiologist can administer a blood patch with the patient's blood to seal the leak. To administer a blood patch, the anesthesiologist inserts a needle into the same space as, or right next to, the area in which the anesthetic 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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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/22/2004
