Reduced risk of headache after lumbar puncture

Lumbar puncture headache is a headache that occurs after a lumbar puncture or spinal puncture, with epidural anesthesia. This is one of the common complications of this procedure.

Lumbar puncture is a procedure to collect and examine the fluid (cerebrospinal fluid puncture, or CSF) surrounding the brain and spinal cord. A lumbar puncture is done to:
- Find a cause for symptoms that could be an infection (such as meningitis), inflammation, cancer, or bleeding in the area around the brain or spinal cord (such as subarachnoid hemorrhage).
- Diagnosis of certain diseases of the brain and spinal cord, such as multiple sclerosis or Guillain-Barré syndrome.
In lumbar puncture :
- A needle is carefully inserted into the low back (lumbar) spinal canal.
- Samples of cerebrospinal fluid are collected. Samples are studied for color, blood cell counts, proteins, glucose, and other substances.
- Some samples may be inserted into growth tubes. This is called a culture.
- If any bacteria or fungi grow in the culture, an infection may be present.
- The pressure of the cerebrospinal fluid is also measured during the procedure.
Lumbar puncture is generally a safe procedure. In some cases, a cerebrospinal fluid (CSF) leak can develop after a lumbar puncture. Symptoms of this problem are headaches that don't go away after 1 to 2 days. CSF leaks can be treated with a blood patch, in which the person's own blood is pumped into the area where the leak has occurred to seal the leak.

During a lumbar puncture procedure, if the epidural needle accidentally passes through the dura that contains CSF, CSF may leak out. A headache that develops due to this problem is called a postdural puncture headache.
The headache that occurs after a lumbar puncture is caused by too much fluid leaking through a small hole in the dura that is created during the procedure. This leak reduces the pressure of cerebrospinal fluid on the brain and spinal cord, leading to a headache.
Lumbar puncture headache usually occurs within 48 hours of lumbar puncture or spinal anaesthesia.
Sometimes, an epidural can also lead to a spinal headache. Although an epidural is injected just outside the membrane surrounding the spinal cord, a spinal tap headache can occur if the dura is inadvertently punctured.

Measures to reduce the risk of headache after lumbar puncture include:
- The first thing to reduce headaches related to the spine is to provide adequate fluid to increase CSF pressure.
- Occasionally, intravenous fluids are given.
- Other times the patient is advised to drink more caffeine.
- The doctor may also require a strict 24-48 hour bed rest.
Also, if a person develops a headache after a lumbar puncture, the anesthesiologist may create a patch with the person's blood to close the leak. To create a blood patch:
- The anesthesiologist will insert a needle into the previous puncture site or right next to it.
- The doctor draws a small amount of blood from the patient and injects it into the epidural space.
- The clot will seal the hole causing the leak.

The above methods are intended to reduce the risk of headache after lumbar puncture. Besides, patients need to have a suitable lifestyle to limit the risk of headache after lumbar puncture.
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