A spinal headache occurs when cerebrospinal fluid (CSF) leaks through a puncture in the membrane that surrounds the spinal cord. This leak decreases the physical support that CSF provides for the brain, causing a headache to occur.
A spinal headache often occurs as a complication of a lumbar puncture, which is a diagnostic procedure
This article discusses the symptoms, causes, diagnosis, treatment, and possible duration of a spinal headache. It also explores when someone should speak with a doctor.
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The symptoms of a spinal headache are much worse when a person sits up or stands up, and can improve with lying down flat.
People often describe occipital headache pain as:
- shooting pain
- shocking pain
- throbbing pain
- burning pain
- aching pain
Other symptoms of a spinal headache may include:
Spinal headaches occur when CSF
A CSF leak may occur as a complication of a number of procedures, including the following procedures.
While these are the most common causes, sometimes a spinal headache
During this procedure, a doctor
A healthcare professional may use a lumbar puncture to diagnose:
A diagnostic myelography (myelogram) is a diagnostic procedure that a doctor can use
During this procedure, a medical professional inserts a dye into a person’s spinal canal. They then use a CT scan or fluoroscopy to observe the dye within the spinal canal. Fluoroscopy is a type of medical imaging that uses a continuous X-ray to allow healthcare professionals to see moving images of an area in the body.
During a subarachnoid block, a medical professional injects anesthetic medications into the fluid in the lower part of the spine.
A subarachnoid block is often an effective alternative to general anesthesia when the site of the surgery is in the lower half of the body.
Epidural anesthesia is a technique that medical professionals use
During an epidural procedure, a medical professional injects anesthetic into the space that surrounds the spinal cord. This causes a person to experience numbness in the surrounding area to the injection site, usually around the abdomen or pelvic region.
A doctor will often diagnose a spinal headache using a clinical evaluation based on a person’s symptoms.
The following steps may help a person manage the symptoms of a spinal headache:
- taking simple analgesics (pain relieving medications)
- oral or intravenous hydration
- avoiding being in an upright position
The symptoms of a spinal headache may also go away on their own without treatment.
If a person has spinal headaches that are severe or persistent, they may require further treatment.
A medical professional may treat severe spinal headaches
Research suggests that the success rate for an epidural blood patch is between
- back pain
- radiculopathy, or damage to the nerves in the lower back
- bulbar neuropathy, or damage to the lower cranial nerves
- meningitis as a result of an infection
- hematoma, which is when an area of blood collects outside of the larger blood vessels
- cauda equina syndrome, which is when the nerve roots in the lumbar spine become compressed
The most common complication of an epidural blood patch is aseptic meningitis. Aseptic meningitis is an inflammatory reaction after the procedure. It causes severe head pain but differs slightly from a spinal headache because it does not worsen with standing up. Treatment for this complication may include an anti-inflammatory medication.
In some cases, a spinal headache can go away on its own
However, for many people, the symptoms can be severe and persistent. In this case, an individual may require medical intervention to help relieve the pain.
If a person experiences the symptoms of a spinal headache they should contact a doctor. This is because symptoms of a spinal headache may interfere with their daily life and can go away with treatment.
A person should also contact a doctor because ongoing headaches
A person should seek immediate medical care if they:
- have a sudden, severe headache alongside a stiff neck
- have a severe headache that is not related to another condition alongside:
- have a headache alongside:
- have a headache that becomes worse over days or weeks or that changes in pattern or behavior over time
- have a headache and a loss of sensation or weakness in any part of the body, this may signal a stroke
- experience two or more headaches a week
- experience a headache in association with convulsions and/or shortness of breath
- have a history of cancer or HIV and AIDS, and experience new headaches
- experience a persistent headache despite previously being headache-free, particularly if they are over the age of 50
A spinal headache occurs when CSF leaks through a puncture in the membrane surrounding the spinal cord. This leak then causes the support that the CSF provides to the brain to decrease. This decrease in pressure causes a person to experience a spinal headache.
A CSF leak can occur as a side effect of certain medical procedures, such as a lumbar puncture, myelogram, subarachnoid block, the administration of epidural anesthesia, or a traumatic injury.
The main symptom of a spinal headache is a bilateral frontal or occipital headache. Other symptoms may include nausea, neck pain, dizziness, visual changes, and numbness or a tingling sensation in the arms. Spinal headache symptoms often become worse when a person stands upright.
A person may treat spinal headaches with analgesics, hydration, and avoiding being in an upright position. A doctor may treat more serious spinal headaches with an epidural blood patch.
People should speak with a doctor if they think they may be experiencing a spinal headache and seek immediate medical attention if they experience a sudden or severe headache.