Spinal headache

Definition

A spinal headache, also known as post-dural puncture headache, is a severe headache that can occur after a procedure such as a spinal tap (lumbar puncture) or epidural block (such as that performed during a woman’s delivery). The headache is typically caused by leakage of spinal fluid through a puncture hole. The headache usually begins within 48 hours after the procedure and can vary in intensity from mild to incapacitating.

Key Takeaways

1. A spinal headache, medically known as a post-dural puncture headache, is a potential complication that can occur post labor in mothers who have received spinal or epidural anesthesia during childbirth.
2. It characteristically presents as a severe headache that worsens when the patient stands or sits up and improves when the patient lies down. This is due to the leakage of cerebrospinal fluid at the puncture site changing the fluid pressure in the brain and spinal column.
3. Treatment options typically involve bed rest with plenty of fluid, caffeine, and pain relievers. In severe cases, an epidural blood patch may be used, where a small amount of the mother’s own blood is injected at the site of the puncture to promote clotting and stop the leakage of cerebrospinal fluid.

Importance

The term “spinal headache” is crucial in motherhood as it refers to a potential side effect some women may experience after undergoing an epidural or spinal anesthesia during childbirth.

The medical term for this condition is a post-dural puncture headache, which occurs when the dura mater, a membrane surrounding the spinal cord, is accidentally punctured.

This can lead to cerebrospinal fluid leak, decreasing the pressure present in the skull, resulting in a characteristic headache that intensifies while sitting or standing and subsides while lying down.

It’s essential for mothers to be aware of this possibility, understand its symptoms, and seek prompt medical assistance to manage it efficiently, ensuring their well-being during the postpartum period.

Explanation

Spinal headaches are predominantly associated with the procedures performed during childbirth, such as epidurals and spinal anesthesia, which involve the insertion of a needle into the spinal canal. They are not intended or purposed to occur, but they can happen as a side effect.

The purpose of spinal anesthesia is to block pain from certain parts of the body during labor by injecting low doses of anesthetic into the lower spine. The use of epidural injections is to provide pain relief during labor by blocking both sensory and motor nerves, offering a numbness that helps reduce or manage the pain of contractions.

However, if during these procedures the dura membrane, which encases the fluid around the spinal cord, is punctured unintetionally, it can lead to a spinal headache. This leakage of spinal fluid can cause a severe, dull, and throbbing headache that gets worse when sitting up or standing and eases when laying down.

The main purpose of diagnosing and attending to these headaches is to minimize the discomfort for the mother post-delivery, ensuring her well-being while she navigates the new phases of motherhood. Treatments may aim to replace lost fluid, relieve pain, and occasionally, seal off the leak of spinal fluid.

Examples of Spinal headache

Spinal headache or post-dural puncture headache is a potential side effect of a spinal block or epidural. Here are three real-world examples related to motherhood:

Childbirth: Spinal blocks and epidurals are commonly administered to women in labor to help alleviate extreme pain. Epidurals involve injecting an anesthetic through the lower back into the area around the spinal cord. Occasionally, the needle can puncture the dural sac causing cerebrospinal fluid (CSF) to leak out, leading to a spinal headache.

Postpartum Procedures: Sometimes after childbirth, women need to undergo procedures such as repairing large birth tears or removing retained placenta parts. These procedures could also require the administration of a spinal block or an epidural, and thus carry the risk of a spinal headache.

C-Sections: C-sections, or cesarean sections, are surgical procedures to deliver the baby. Anesthetics used during this procedure are often delivered through a spinal block or epidural, which again brings the risk of a spinal headache.

FAQs on Spinal Headache

What is a Spinal Headache?

A spinal headache, also known as a post-dural puncture headache, occurs when the dura mater, a membrane surrounding the spinal cord, is punctured. This can happen accidentally during an epidural or spinal anesthesia procedure. The puncture can lead to cerebrospinal fluid leaking out, reducing its pressure and resulting in a headache.

What are the symptoms of a Spinal Headache?

Spinal headaches typically have a distinct set of symptoms. The primary one is a dull, throbbing pain that can range from mild to very severe. The headache often gets worse when you sit up or stand and decreases when you lay down flat. Other symptoms can include dizziness, a stiff neck, changes in hearing, and nausea.

How are Spinal Headaches treated?

Treatment for spinal headaches focuses on relieving symptoms and preventing more cerebrospinal fluid from leaking. In some cases, bed rest and plenty of fluids are recommended, as both can help replenish lost cerebrospinal fluid. Pain relievers can also be used to manage the headache. In other cases, an epidural blood patch may be applied to stop the leak.

Can a Spinal Headache be prevented?

The best way to prevent a spinal headache is through careful procedures during epidural or spinal anesthesia to avoid puncturing the dura mater. If a puncture does happen, it’s important to lay flat and hydrate immediately after the procedure. This can help replace lost fluid and prevent the onset of a headache.

Are Spinal Headaches long-term?

Most spinal headaches go away within 24 hours. However, some can last a week or even longer. In rare cases, serious complications can arise, such as chronic headaches, subdural hematoma, or even meningitis. If a spinal headache does not go away after a week or if symptoms become severe, medical attention should be sought immediately.

Related Motherhood Terms

• Post-Dural Puncture
• Spinal Anesthesia
• Epidural Blood Patch
• Lumbar Puncture
• Meninges

Sources for More Information

• Mayo Clinic: An established medical resource that contains a wealth of information on health topics including spinal headaches.
• WebMD: A trusted online health platform that handles a wide array of health topics including post-dural puncture headaches.
• Healthline: This comprehensive health information site includes specific articles and resources on spinal headaches.
• Centers for Disease Control and Prevention (CDC): The CDC is a reliable resource for health information, including complications related to childbirth such as spinal headaches.