Spinal headaches 

Overview  

A spinal headache is a highly intense type of headache that arises when there’s a decrease in the level of cerebrospinal fluid (CSF) enveloping the brain. This reduction can occur following procedures like a spinal tap (lumbar puncture) or due to the leakage of CSF caused by tears or cysts in the protective meninges covering the spinal cord. The CSF layer serves to safeguard the brain and spinal cord, providing cushioning against abrupt movements and supplying essential nutrients. 

A spinal tap involves the extraction of a small CSF sample from the spinal canal, while spinal anesthesia entails injecting medication into the same canal to numb lower body nerves. If spinal fluid leaks through the puncture site, it can trigger the onset of a spinal headache. These headaches are also termed post–dural puncture headaches and are commonly associated with spinal procedures. They may alternately be referred to as epidural headaches or low–pressure headaches. 

In most cases, spinal headaches tend to subside on their own without necessitating treatment. However, instances of severe spinal headaches that persist for 24 hours or more might require medical attention. These headaches can be particularly distressing due to the decreased CSF cushioning around vital neurological structures.  

Symptoms  

Symptoms of a spinal headache consist of:  

• A dull, throbbing pain that ranges in severity from barely perceptible to excruciating  
• Pain that usually increases when you sit up or stand and reduces or disappears when you lie down.  

Spinal headaches frequently come with:  

• Dizziness  
• Nausea  
• Vomiting  
• Seizures  
• Stiff neck   
• Neck pain  
• Tinnitus  
• Eye problem (double or blurred vision)  
• Losing your hearing  
• Photophobia or being sensitive to light.  

If you experience a headache following a spinal tap or spinal anesthetic, let your doctor know right away, especially if it grows worse as you sit up or stand.  

Causes  

Spinal headaches result from the leakage of spinal fluid due to a puncture in the dura mater, the spinal cord’s protective membrane. This leakage reduces the pressure of spinal fluid on the brain and spinal cord, leading to a headache. These headaches usually manifest within 48 to 72 hours following a spinal tap or spinal anesthesia. In some cases, epidural anesthesia can also cause spinal headaches if it accidentally punctures the surrounding membrane, despite being administered just outside it. 

Risk factors  

The following are risk factors for spine headaches:  

• Age: Being between 18 and 30 years old. 
• Gender: Being female. 
• Pregnancy: Being pregnant. 
• Headache History: Having a history of frequent headaches. 
• Medical Procedures: Undergoing procedures that use larger needles or involve multiple punctures in the membrane around the spinal cord.
• Body Size: Having a smaller body mass.