Causes and risk factors
Spinal anaesthesia and LP both these procedures involve puncture of membranes that surround the spinal cord [between lumbar and sacral nerve roots]. Spinal fluid leaks through the small punctured site. The leakage lowers the intracranial pressure and pressure on spinal cord causing headache. It can also result after an epidural anaesthesia. Risk factors for spinal headache include being female, age between 18 to 30, repeated spinal anaesthesia or LP, history of spinal headaches in past.
Clinical presentation
Spinal headache occurs within 12-24 hours after the spinal anaesthesia or LP procedure. The pain is very severe which is never experienced by the patient before. Pain is increased on becoming upright or straining and reduced by lying down.
Investigation
Medical history of surgeries under spinal anaesthesia or LP procedures by the patient and Clinical examination by the doctor helps in diagnosis. MRI may be advised to rule out other causes of headache.
Treatment
Conservative treatment is required for spinal headaches occurring within 24 hours. Sufficient and adequate hydration of patient by oral and intravenous routes is done to treat spinal headache. Medications like analgesics or NSAIDs may help in relieving headache in first few hours. If headache doesn’t subside after 24 hours, treatment involves epidural blood patch i.e. injecting small amount of blood through the punctured site, intravenous infusion of caffeine, will help in managing spinal headache.
Other Modes of treatment
The other modes of treatment can also be effective in treating spinal headache. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating spinal headache.
