Spinal headache

Spinal Headache

A spinal headache, also known as a post-dural puncture headache (PDPH), is a form of headache that occurs as a complication of a procedure involving a puncture of the dura mater, the outer membrane of the central nervous system. This condition is most commonly associated with lumbar puncture (spinal tap) and the administration of spinal anesthesia, but it can also occur following other medical procedures that involve the dura mater.

Causes

The primary cause of a spinal headache is the leakage of cerebrospinal fluid (CSF) through a puncture hole in the dura mater. When the CSF volume decreases, it leads to a reduction in the pressure exerted by the fluid on the brain and spinal cord, which in turn can cause the brain to sag within the skull, leading to a headache. This type of headache is positional, typically worsening when the patient is upright and improving when the patient is lying down.

Symptoms

Symptoms of a spinal headache include:

• Headache that worsens when sitting or standing and improves when lying down
• Nausea and vomiting
• Neck stiffness
• Dizziness
• Photophobia (sensitivity to light)
• Phonophobia (sensitivity to sound)

Diagnosis

Diagnosis of a spinal headache is primarily based on the patient's history, especially a recent history of a dural puncture, and the characteristic symptoms. In some cases, imaging tests such as magnetic resonance imaging (MRI) may be used to rule out other causes of headache.

Treatment

Treatment options for spinal headaches include:

• Conservative measures, such as bed rest, hydration, and caffeine intake
• Administration of a blood patch, which involves injecting the patient's own blood into the epidural space near the site of the dural puncture to promote clotting and seal the leak

Prevention

Preventive measures for spinal headaches focus on minimizing the risk of dural puncture during medical procedures. This can include the use of smaller needles and precise technique during lumbar punctures and spinal anesthesia.

See Also

• Lumbar puncture
• Cerebrospinal fluid
• Dura mater
• Central nervous system