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• #1 Spinal headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-headaches/symptoms-causes/syc-20377913

  Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the membrane (dura mater) that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache. […] Sometimes epidural anesthesia may lead to a spinal headache as well. Although epidural anesthetic is injected just outside the membrane that surrounds the spinal cord, a spinal headache is possible if the membrane is unintentionally punctured.

• #1 Spinal Headache: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17927-spinal-headaches

  A spinal headache is an intense headache that can result from a spinal tap (lumbar puncture), like an epidural. It happens when cerebrospinal fluid leaks out. […] Spinal headaches happen when cerebrospinal fluid around your brain decreases, usually due to a spinal tap or meningeal tear. Leakage of cerebrospinal fluid can cause the tissues and nerves that support your brain to stretch, resulting in headache pain. […] The most common cause of a spinal headache is a puncture (hole) created during a spinal tap or lumbar puncture. […] The loss of fluid results in low CSF pressure around your brain (intracranial hypotension). This causes your brain to sag downward. The surrounding nerves and tissues become stretched, which results in a headache. […] Other conditions can cause spinal fluid leaks that lead to spinal headaches, including: A ruptured (burst) cyst on your spinal cord. A tear in the meninges of your spinal cord. A head or face injury, such as a fractured skull.

• #1 Spinal headache: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/spinal-headache

  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. […] Spinal headaches occur when CSF leaks from the spinal cord, and it can occur due to a puncture during a medical procedure, or as a result of trauma or disease. This leak causes the support that the CSF provides around the brain to decrease. […] While these are the most common causes, sometimes a spinal headache can occur from a leak due to trauma, primary or metastatic spine cancer or spinal cord cancer, or after spine surgery. It has also rarely been reported after heavy lifting or without a known cause. […] 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.

• #1 Postdural Puncture Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430925/

  Postdural puncture headache (PDPH) is a potential complication associated with a lumbar puncture characterized by a bilateral frontal or occipital headache that is worse when the patient is in an upright position, nausea, neck pain, dizziness, visual changes, tinnitus, hearing loss, or radicular symptoms in the arms. […] The underlying cause of the PDPH is an intentional dural puncture performed during a lumbar puncture that is necessary for diagnostic myelography, the instillation of various therapeutic medications into lumbar subarachnoid space, or following the inadvertent dural puncture that results while administering epidural anesthesia or when medications are injected for spinal pain. […] Other low-CSF pressure symptoms suggestive of intracranial hypotension can also develop spontaneously or following craniotomy, placement of intraventricular shunts for CSF diversion, brain/spinal trauma, or spinal surgery.

• #1 Spinal Headache: Symptoms, Causes, Complications and Treatment

  https://www.carehospitals.com/indore/diseases-conditions/spinal-headache

  Most people have experienced regular headaches, but spinal headaches represent a distinct and often misunderstood medical condition that requires special attention. […] The primary cause of spinal headaches stems from an accidental puncture of the dura mater, the protective membrane surrounding the spinal cord and brain. This typically occurs during common medical procedures such as epidural injections, lumbar punctures, or specific types of spinal surgeries. Even though epidural anaesthetics are injected outside the membrane surrounding the spinal cord, accidental punctures of that membrane can result in spinal headaches. […] Several medical conditions can also trigger spinal fluid leaks, including: A ruptured cyst on the spinal cord, A tear in the spinal cord meninges, Head or face injuries, particularly fractured skulls.

• #1 CSF leak (Cerebrospinal fluid leak) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. When there is a hole or tear in the outermost layer, a CSF leak occurs. […] A spinal CSF leak occurs anywhere in the spinal column. […] Spinal CSF leaks may be caused by: […] A spinal tap, also called a lumbar puncture. […] An epidural in the spine for pain relief, such as during labor and delivery. […] An injury to the head or spine. […] Bone spurs along the spine. […] Irregularities of the dura mater around the nerve roots in the spine. […] Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. […] Prior surgery on the spine. […] When there is no surgery or procedure prior to the start of a CSF leak, it is called a spontaneous CSF leak.

• #1 Spinal Headaches: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/migraine-and-headache/spinal-headache

  Sometimes CSF leaks happen spontaneously, or without an obvious cause. Researchers are still investigating why spontaneous CSF leaks happen, but they may be linked to having a weak dura. […] CSF leakage reduces pressure around the brain, causing pain by: causing traction on sensitive structures such as the blood vessels and nerves, slight sagging of the brain, dilation and inflammation of blood vessels, glands, and other structures in the head. […] A spinal headache is when CSF leaks from a puncture wound. […] Spinal headaches often go away on their own, but treatment can help alleviate symptoms and support recovery.

• #1 Postdural Puncture Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430925/

  Factors associated with a higher risk for PDPH include: Dehydration, Various systemic illnesses, Use of a large caliber or cutting needle to access the CSF, Female gender, Pregnancy, Younger age (20 to 40 years), Prior history of headaches, Inexperienced proceduralist. […] Additionally, PDPH is more common in patients with a low body mass index and those patients with prior headaches, especially after a prior PDPH. […] PDPH is uncommon in older adults, most likely due to the presence of cerebral atrophy. […] Other risk factors for PDPH include the caliber of the spinal needle and the use of a cutting needle, especially if, after insertion, the needle is rotated perpendicular to the long axis of the dural fibers. […] The physician’s experience in performing a lumbar puncture, the number of lumbar punctures performed, and the removal of large amounts of CSF fluid may or may not be related to the incidence of PDPH. […] The patient in a sitting or lateral decubitus position either during or after the lumbar puncture is unrelated to the development of a PDPH.

• #1

  https://healthmatch.io/migraine/spinal-migraine

  Pregnancy confers an additional risk for PDPH, possibly due to increased cerebral vasodilation in response to CSF hypotension. […] People who have experienced chronic headaches in the past are at risk of developing PSPH. […] Although studies are contradicting, it has historically been thought that people with a lower body mass index (BMI) are at a higher risk of developing spinal migraine than those with a higher BMI. […] The amount of CSF leaking after a lumbar puncture is directly proportional to the size of the dural tear. […] To reduce spinal headaches after lumbar puncture, using noncutting (atraumatic) needles is recommended. […] The more lumbar puncture attempts, the larger the size of dura damage and the more the likelihood of spinal headache. […] If you develop a spinal headache after the procedure, you should lay supine to help manage the pain.

• #1 Post dural puncture headache – UpToDate

  https://www.uptodate.com/contents/post-dural-puncture-headache

  Post dural puncture headache (PDPH), also known as post lumbar puncture (LP) headache, is a common complication of diagnostic LP. It also can occur following spinal anesthesia or, more commonly, inadvertent dural puncture during attempted epidural catheter placement. The headache is usually positional (worse when upright, better when lying flat) and is often accompanied by neck stiffness, photophobia, nausea, or subjective hearing symptoms. […] The precise etiology of headache after dural puncture is unclear, but is thought to relate to leakage of cerebrospinal fluid (CSF) through the dural hole created by the needle. If CSF leaks at a rate greater than the rate of CSF production, low CSF pressure can result, accentuated at the level of the brain in the upright position. However, not all patients with PDPH have low CSF pressure, and not all patients with significant CSF leak develop a headache.

• #1 Post dural puncture headache – UpToDate

  https://www.uptodate.com/contents/post-dural-puncture-headache

  Three pathophysiologic mechanisms have been proposed: […] CSF hypotension results in compensatory meningeal venodilation and blood volume expansion, with headache caused by acute venous distention. This mechanism is consistent with magnetic resonance imaging (MRI) in several reported cases of PDPH.

• #1 Headache: What It Is, Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9639-headaches

  Spinal headaches: Spinal headaches are intense headaches that occur when spinal fluid leaks out of the membrane covering your spinal cord, usually after a spinal tap. Most spinal headaches can be treated at home, but prolonged, untreated spinal headaches can cause life-threatening complications, including subdural hematoma and seizures.

• #1 Statement on Post-Dural Puncture Headache Management | American Society of Anesthesiologists (ASA)

  https://www.asahq.org/standards-and-practice-parameters/statement-on-post-dural-puncture-headache-management

  Postpartum morbidity following PDPH include readmission (5.2%), increased relative risk for cerebral venous thrombosis (aOR = 11.4) and subdural hematoma (aOR = 76.7).7 […] The International Headache Society (IHS) defines PDPH as a headache occurring within 5 days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. […] Low intracranial CSF volume or intracranial hypotension may develop due to an intentional (spinal anesthesia) or unintended dural puncture (UDP) causing a loss of CSF into the epidural space through the dural hole leading to a fall in CSF pressure. […] The proposed mechanism regarding the formation of an intracranial subdural hematoma after UDP is from decreased intracranial pressure placing traction on the bridging veins between the dura and arachnoid, resulting in their tearing and subsequent hematoma formation. […] Emerging data from 5 retrospective and 3 prospective studies support an association between PDPH, especially after unintentional dural puncture with an epidural needle, with chronic headache sequelae.

• #1 Post-epidural headaches can be more serious than previously known – Scope

  https://scopeblog.stanford.edu/2021/08/02/post-epidural-headaches-can-be-more-serious-than-previously-known/

  In about 1% of cases, the needle advances deeper than intended and punctures the spinal membrane and causes a large leak of spinal fluid, which can cause headaches, said Ansari, clinical assistant professor of anesthesiology. […] It’s not clear what causes the headaches, but during the past 10 years there has been a growing body of evidence showing that they may be more serious and persistent than previously thought, Flood said. […] We have confirmed in this well-powered prospective study that women who had unintentional dural punctures from an epidural needle have double the risk for chronic headaches compared to new moms who did not have this complication, Flood said. […] Ansari said the study findings mean that these women should be carefully followed to support them and further investigate ways to treat spinal headaches.

• #1 Lumbar Puncture Headache: Your Questions Answered

  https://www.healthline.com/health/headache/lumbar-puncture-headache

  Long-term complications of a spinal headache are rare. […] Other possible risks associated with a spinal tap include: bleeding, infections, swelling, a chronic headache that may last for months. […] Theres no sure way to prevent lumbar puncture headaches. […] A lumbar puncture headache is a common side effect after undergoing a spinal tap procedure. It develops when the hole in your spine from the puncture doesnt close all the way, allowing spinal fluids to leak out of the site.

• #1 Spinal Headache

  https://mobile.fpnotebook.com/Neuro/Headache/SpnlHdch.htm

  Orthostatic Headache with CSF Leak or procedure […] Lumbar Puncture with opening pressure of 6 cm H2O […] No other pathologic cause […] Use a small gauge spinal needle (20 to 22) for Lumbar Puncture […] Use non-Traumatic, blunt, non-cutting needle for Lumbar Puncture […] Minimize number of Lumbar Puncture attempts […] Intravenous Fluids prior to Lumbar Puncture […] Does not decrease Spinal Headache Incidence but may decrease duration […] Bedrest for at least 1 hour following Lumbar Puncture does not appear to affect postdural headache Incidence.

• #1 Reddit – The heart of the internet

  https://www.reddit.com/r/BabyBumps/comments/168yvea/spinal_headaches/

  I just had my baby on Tuesday, and want to put this PSA out for any first-timers. If you got an epidural or spinal and have a headache after, don’t let your care team dismiss your pain. It could be a spinal fluid leak, and you might need a blood patch to treat it. […] I had 3 epidurals (the first 2 didn’t work) attempting vaginal delivery Monday and then a spinal block for an emergency c-section Tuesday morning. For days after, I had a headache that felt like a cannonball smashing the back of my head through my face any time I was upright. […] I finally got a diagnosis and the blood patch, and it was like magic.

• #1 Post-Lumbar Puncture Headache Etiology and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1026172/

  Headache following a lumbar puncture is a common and often debilitating syndrome. Continued leakage of cerebrospinal fluid from a puncture site decreases intracranial pressure, which leads to traction on pain-sensitive intracranial structures. […] The headache is characteristically postural, often associated with nausea and optic, vestibular, or otic symptoms. […] Although usually self-limited after a few days, severe postural pain can incapacitate the patient. […] Management is mainly symptomatic, but definitive treatment with the epidural blood patching technique is safe and effective when done by an expert operator.

• #2 Spinal Headache: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17927-spinal-headaches

  A spinal headache is an intense headache that can result from a spinal tap (lumbar puncture), like an epidural. It happens when cerebrospinal fluid leaks out. […] Spinal headaches happen when cerebrospinal fluid around your brain decreases, usually due to a spinal tap or meningeal tear. Leakage of cerebrospinal fluid can cause the tissues and nerves that support your brain to stretch, resulting in headache pain. […] The most common cause of a spinal headache is a puncture (hole) created during a spinal tap or lumbar puncture. […] The loss of fluid results in low CSF pressure around your brain (intracranial hypotension). This causes your brain to sag downward. The surrounding nerves and tissues become stretched, which results in a headache. […] Other conditions can cause spinal fluid leaks that lead to spinal headaches, including: A ruptured (burst) cyst on your spinal cord. A tear in the meninges of your spinal cord. A head or face injury, such as a fractured skull.

• #2 Spinal Headache: Causes, Prevention, Treatment & Complications

  https://www.denveruppercervical.com/spinal-headache

  A spinal headache is triggered when fluid leaks from your spine. The leakage decreases the fluid pressure around your brain, causing it to sag downward. When the brain sags, it stretches the surrounding nerves, creating intense head pain. […] There are some predictable risk factors for getting this type of headache. For instance, spinal headaches occur in a third of people who receive a spinal tap (also called a lumbar puncture). […] Most spinal headaches are caused by a spinal tap. A spinal tap is when a doctor or anesthesiologist inserts analgesics through a spinal needle into the spinal canal in the lower back. […] Sometimes, the needle can leave a puncture site where spinal fluid leaks out of the epidural space. […] Other causes of spinal headaches include a ruptured cyst on the spinal cord and head/face/skull trauma. Either of these may cause spinal fluid to leak, resulting in low CSF pressure around the brain (intracranial hypotension). […] The risk factors for spinal headaches include: spinal tap procedure in the last two weeks, recent head injury, pregnancy, low BMI (body mass index), age 18 to 30 years old, female (women are more likely to get a spinal headache).

• #2 Spinal Headaches from Epidural or Lumbar Puncture

  https://www.webmd.com/migraines-headaches/pain-management-spinal-headaches

  A spinal headache is the name for a type of headache that follows a procedure like a spinal tap (lumbar puncture) or epidural block (such as that performed during labor and delivery). […] During a spinal tap, a needle is placed within the fluid-filled space that surrounds your spinal cord. This creates a passage for the spinal fluid to leak out, which changes the fluid pressure around your brain and spinal cord. If enough of the fluid leaks out, you may get a spinal headache. […] Because the design of spinal needles has improved, spinal headaches after you get a spinal tap or spinal anesthesia are rare. The odds are usually low after an epidural, too, unless the needle accidentally punctures the dura mater, a tough membrane that covers your spinal cord.

• #2 Spinal Headaches: Causes, Symptoms, and Treatment OptionsShare to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://migraine.com/headache-types/spinal-headaches

  Up to 30% of people who have spinal tap develop spinal headaches. The spinal tap, which is also called a lumbar puncture, involves using a needle to take fluid from the spinal canal. […] If spinal fluid leaks out when the spinal fluid is extracted, the fluid pressure around the spinal cord and brain can cause a spinal headache. The head pain results if the needle accidentally passes through the dura matter which covers the spinal cord, which causes the leakage. […] Spinal headaches can cause severe head pain which often worsens upon sitting upright.

• #2 Spinal headache: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/spinal-headache

  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. […] Spinal headaches occur when CSF leaks from the spinal cord, and it can occur due to a puncture during a medical procedure, or as a result of trauma or disease. This leak causes the support that the CSF provides around the brain to decrease. […] While these are the most common causes, sometimes a spinal headache can occur from a leak due to trauma, primary or metastatic spine cancer or spinal cord cancer, or after spine surgery. It has also rarely been reported after heavy lifting or without a known cause. […] 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.

• #2 The Symptoms and Causes of Spinal Headaches – Colorado Pain Care

  https://coloradopaincare.com/the-symptoms-and-causes-of-spinal-headaches/

  If you have undergone a spinal tap or epidural block procedure, your doctor may have warned you that you may be at risk of a spinal headache. Because these procedures sometimes involve a puncture of the dura mater, the tough outer membrane that encases the spinal cord, spinal fluid may leak out. With the loss of a significant amount of spinal fluid, you may experience headaches that can range in intensity from mild to incapacitating. […] The main initial cause of spinal headaches is any loss of structural integrity in the dura mater. Whether this is from a surgical procedure like a spinal tap or from an injury, the resulting leakage of cerebrospinal fluid (CSF) decreases the fluid pressure on the brain and spinal cord. […] Although the most common causes of spinal headaches are procedures involving the spine, some people are at greater risk for these complications. People with Marfan syndrome, Ehlers-Danlos syndrome or polycystic kidney disease have weaker connective tissue and are more susceptible to tears in the meninges surrounding the brain and spinal cord.

• #2 Positional headache not always a spinal CSF leak – Spinal CSF Leak Foundation

  https://spinalcsfleak.org/positional-headache-not-always-spinal-csf-leak/

  The headache associated with intracranial hypotension (low fluid pressure inside the head) secondary to a spinal cerebrospinal fluid (CSF) leak is usually positional that is, it is head pain that is worse when upright but improved when horizontal. […] When a patient goes to a physician with symptoms of a new onset positional headache, spontaneous intracranial hypotension secondary to a spinal CSF leak should always be considered. […] Spontaneous spinal CSF leaks arise in many cases from a weakness of the dura, the connective tissue outer layer of the meninges surrounding the spinal cord and brain. An underlying heritable disorder of connective tissue is found or suspected in many of these patients. Ehlers Danlos syndrome (EDS) is one of several heritable disorders of connective tissue seen in spontaneous spinal CSF leak patients.

• #2 The Symptoms and Causes of Spinal Headaches – Colorado Pain Care

  https://coloradopaincare.com/the-symptoms-and-causes-of-spinal-headaches/

  There are many factors that may increase your risk of spinal headaches, so discuss them with your doctor prior to any spinal or brain procedure: Using a needle larger than 24-25 gauge in a procedure, Positioning needle perpendicular to the spinal cord rather than at acute angle, Female gender, Pregnant, Younger age between 30 and 50, Any history of chronic headache prior to the surgery.

• #2 5 Options for Spinal Headache Treatment | SSOR

  https://ssorkc.com/5-options-for-spinal-headache-treatment/

  The size of the needle can play a direct factor in developing a spinal headache. If a larger needle is used, the chances of cerebrospinal fluid leaking increases. A larger needle used in the procedure can come with a chance of up to 70% of developing a spinal headache. If a smaller needle is used, the chance can be 12% of developing a spinal headache. […] The kind of needle can also play a factor in the risk of developing a spinal headache. If an atraumatic needle that has a diamond-shaped tip is used for the procedure, you have a lower chance of developing a headache. […] The number of attempts directly relates to the amount of damage in the spinal canal. If a larger needle or multiple attempts are required, the damage to the spinal canal will leave a more significant chance of spinal fluid leaking into the canal, which can lead to the development of a headache.

• #2

  https://healthmatch.io/migraine/spinal-migraine

  Pregnancy confers an additional risk for PDPH, possibly due to increased cerebral vasodilation in response to CSF hypotension. […] People who have experienced chronic headaches in the past are at risk of developing PSPH. […] Although studies are contradicting, it has historically been thought that people with a lower body mass index (BMI) are at a higher risk of developing spinal migraine than those with a higher BMI. […] The amount of CSF leaking after a lumbar puncture is directly proportional to the size of the dural tear. […] To reduce spinal headaches after lumbar puncture, using noncutting (atraumatic) needles is recommended. […] The more lumbar puncture attempts, the larger the size of dura damage and the more the likelihood of spinal headache. […] If you develop a spinal headache after the procedure, you should lay supine to help manage the pain.

• #2 Post dural puncture headache – UpToDate

  https://www.uptodate.com/contents/post-dural-puncture-headache

  Three pathophysiologic mechanisms have been proposed: […] CSF hypotension results in compensatory meningeal venodilation and blood volume expansion, with headache caused by acute venous distention. This mechanism is consistent with magnetic resonance imaging (MRI) in several reported cases of PDPH.

• #2 Spinal Headache – Obstetrical Anesthesia Associates

  https://obepidural.com/patient-education/spinal-headache/

  A spinal headache, also known as a post-dural puncture headache (PDPH), is the most common complication of epidural, spinal, or combined spinal-epidural (CSE) anesthesia. A spinal headache happens as a result of a hole being accidentally made in the membrane that separates the epidural and spinal space (the dura) with a large needle. This is called a wet tap or accidental dural puncture (as opposed to the intentional dural puncture that happens with a much smaller needle when a spinal or CSE is performed). The incidence of wet tap is about 0.5-1% anytime a needle is placed in your back for regional anesthesia (the general term for epidural, spinal, and CSE). The risk of wet tap and resulting headache are the same no matter what form of regional anesthesia you have. […] When the epidural was placed, a hole was made in the water balloon that is big enough that it doesnt close over right away which results in fluid leaking out. That fluid in the water balloon is spinal fluid which your body makes every day. However, there is a maximal limit to the amount of spinal fluid that your body can make in a 24 hour period so the leak outpaces your bodys ability to make spinal fluid and the water level in your balloon drops. What that means is that whenever you are upright, the pencil (your brain) sags because it is not being held up by as much fluid. This puts tension on the brain and creates that throbbing headache.

• #2 Lumbar Puncture Headache: Your Questions Answered

  https://www.healthline.com/health/headache/lumbar-puncture-headache

  Long-term complications of a spinal headache are rare. […] Other possible risks associated with a spinal tap include: bleeding, infections, swelling, a chronic headache that may last for months. […] Theres no sure way to prevent lumbar puncture headaches. […] A lumbar puncture headache is a common side effect after undergoing a spinal tap procedure. It develops when the hole in your spine from the puncture doesnt close all the way, allowing spinal fluids to leak out of the site.

• #2 Post-epidural headaches can be more serious than previously known – Scope

  https://scopeblog.stanford.edu/2021/08/02/post-epidural-headaches-can-be-more-serious-than-previously-known/

  In about 1% of cases, the needle advances deeper than intended and punctures the spinal membrane and causes a large leak of spinal fluid, which can cause headaches, said Ansari, clinical assistant professor of anesthesiology. […] It’s not clear what causes the headaches, but during the past 10 years there has been a growing body of evidence showing that they may be more serious and persistent than previously thought, Flood said. […] We have confirmed in this well-powered prospective study that women who had unintentional dural punctures from an epidural needle have double the risk for chronic headaches compared to new moms who did not have this complication, Flood said. […] Ansari said the study findings mean that these women should be carefully followed to support them and further investigate ways to treat spinal headaches.

• #2 Spinal Headache

  https://mobile.fpnotebook.com/Neuro/Headache/SpnlHdch.htm

  Orthostatic Headache with CSF Leak or procedure […] Lumbar Puncture with opening pressure of 6 cm H2O […] No other pathologic cause […] Use a small gauge spinal needle (20 to 22) for Lumbar Puncture […] Use non-Traumatic, blunt, non-cutting needle for Lumbar Puncture […] Minimize number of Lumbar Puncture attempts […] Intravenous Fluids prior to Lumbar Puncture […] Does not decrease Spinal Headache Incidence but may decrease duration […] Bedrest for at least 1 hour following Lumbar Puncture does not appear to affect postdural headache Incidence.

• #2 Statement on Post-Dural Puncture Headache Management | American Society of Anesthesiologists (ASA)

  https://www.asahq.org/standards-and-practice-parameters/statement-on-post-dural-puncture-headache-management

  Postpartum morbidity following PDPH include readmission (5.2%), increased relative risk for cerebral venous thrombosis (aOR = 11.4) and subdural hematoma (aOR = 76.7).7 […] The International Headache Society (IHS) defines PDPH as a headache occurring within 5 days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. […] Low intracranial CSF volume or intracranial hypotension may develop due to an intentional (spinal anesthesia) or unintended dural puncture (UDP) causing a loss of CSF into the epidural space through the dural hole leading to a fall in CSF pressure. […] The proposed mechanism regarding the formation of an intracranial subdural hematoma after UDP is from decreased intracranial pressure placing traction on the bridging veins between the dura and arachnoid, resulting in their tearing and subsequent hematoma formation. […] Emerging data from 5 retrospective and 3 prospective studies support an association between PDPH, especially after unintentional dural puncture with an epidural needle, with chronic headache sequelae.

• #2 Spinal Headache – Obstetrical Anesthesia Associates

  https://obepidural.com/patient-education/spinal-headache/

  The very unusual thing about a spinal headache is the fact that you will have these symptoms whenever you are upright (even propped up on pillows) but they lessen significantly or even disappear whenever you lay flat. […] A spinal headache can last for a week or more and can be very difficult for a new mother to handle, given the demands of caring for your infant. […] The gold-standard for treating a spinal headache is a procedure call an epidural blood patch. During an epidural blood patch, we draw blood from you in a sterile manner and inject it into your epidural space. […] One of the jobs of your blood in your body is to find broken places and try to heal them. The first step in this is that little platelets in your blood stick together at the edges of damaged tissue. Your blood will do the same thing to the hole in your spinal sac and essentially form a cork that will plug the hole and the leak.

• #3 Mayo Clinic Health Library – Spinal headaches | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20377900

  Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the membrane (dura mater) that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache. […] Spinal headaches typically appear within 48 to 72 hours after a spinal tap or spinal anesthesia. […] Sometimes epidural anesthesia may lead to a spinal headache as well. Although epidural anesthetic is injected just outside the membrane that surrounds the spinal cord, a spinal headache is possible if the membrane is unintentionally punctured.

• #3 Spinal Headaches: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/migraine-and-headache/spinal-headache

  Sometimes CSF leaks happen spontaneously, or without an obvious cause. Researchers are still investigating why spontaneous CSF leaks happen, but they may be linked to having a weak dura. […] CSF leakage reduces pressure around the brain, causing pain by: causing traction on sensitive structures such as the blood vessels and nerves, slight sagging of the brain, dilation and inflammation of blood vessels, glands, and other structures in the head. […] A spinal headache is when CSF leaks from a puncture wound. […] Spinal headaches often go away on their own, but treatment can help alleviate symptoms and support recovery.

• #3 CSF leak (Cerebrospinal fluid leak) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/csf-leak/symptoms-causes/syc-20522246

  Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and provides a cushion to protect them from injury. When there is a hole or tear in the outermost layer, a CSF leak occurs. […] A spinal CSF leak occurs anywhere in the spinal column. […] Spinal CSF leaks may be caused by: […] A spinal tap, also called a lumbar puncture. […] An epidural in the spine for pain relief, such as during labor and delivery. […] An injury to the head or spine. […] Bone spurs along the spine. […] Irregularities of the dura mater around the nerve roots in the spine. […] Irregular connections between dura mater and veins. These are referred to as CSF-venous fistulas. […] Prior surgery on the spine. […] When there is no surgery or procedure prior to the start of a CSF leak, it is called a spontaneous CSF leak.

• #3 Spinal headache: A headache that occurs after spinal anesthesia, due to leakage of cerebrospinal fluid.

  https://www.laparoscopyhospital.com/worldlaparoscopyhospital/index.php?pid=649&p=4

  Spinal headache: A headache that occurs after spinal anesthesia, due to leakage of cerebrospinal fluid. […] A spinal headache, also known as a post-dural puncture headache (PDPH), is a type of headache that occurs after a spinal tap or spinal anesthesia. It is caused by a leakage of cerebrospinal fluid (CSF) through the puncture site in the spinal canal. […] Spinal headaches occur when there is a leakage of CSF from the puncture site in the spinal canal. This can happen during a spinal tap (lumbar puncture) or spinal anesthesia, where a needle is inserted into the spinal canal to remove fluid or administer medication. The leakage of CSF causes a decrease in the pressure within the spinal canal, leading to the characteristic headache. […] The risk of developing a spinal headache is higher in certain individuals, including pregnant women, individuals with a history of migraines, and those with connective tissue disorders such as Ehlers-Danlos syndrome. Additionally, the size of the needle used during the procedure and the technique used can also affect the likelihood of developing a spinal headache.

• #3 Headache When Sitting or Standing – Spinal Headaches | NHI

  https://nationalheadacheinstitute.com/blog/spinal-headaches/

  Spinal headaches tend to be worse when you are sitting or standing up and improve immediately when lying down. […] A spinal headache can often occur after certain procedures such as a lumbar puncture, a spinal tap or an epidural block. In fact, over 40% of patients receiving these procedures report a spinal headache immediately afterwards. […] During these procedures, a thin needle is used to create a passage to the spine and this is when spinal fluid can leak. The change in fluid pressure around the spinal cord and brain can cause a spinal headache to occur.

• #3 Spinal Headaches: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/migraine-and-headache/spinal-headache

  A spinal headache develops when cerebrospinal fluid (CSF) that surrounds the brain and spinal cord leaks. It often occurs as a complication of a lumbar puncture, but injury and surgery can also be responsible. […] Spinal headaches can be caused by medical procedures and injury to the spinal cord or head. […] Spinal headaches are caused by CSF leaking from the spinal cord. This happens as a result of puncturing the spinal dura — a tube-like membrane that surrounds the spinal cord. […] Punctures and CSF leaks can happen due to procedures that involve puncturing the dura on purpose, such as: a spinal tap or lumbar puncture procedure, spinal injections, such as giving epidural anesthesia, injury to the brain or spine, brain or spinal surgery, spinal conditions, such as spinal meningeal diverticula, whereby the dura or other structures around the spinal cord bulge outward.

• #3 Post-dural-puncture headache – Wikipedia

  https://en.wikipedia.org/wiki/Post-dural-puncture_headache

  Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). […] PDPH is a common side effect of lumbar puncture and spinal anesthesia. Leakage of cerebrospinal fluid causes reduced fluid pressure in the brain and spinal cord. […] PDPH is thought to result from a loss of cerebrospinal fluid into the epidural space. A decreased hydrostatic pressure in the subarachnoid space then leads to traction to the meninges with associated symptoms. […] Estimates for the overall incidence of PDPH vary between 0.1% and 36%. It is more common in younger patients (especially in the 18-30 age group), women (especially those who are pregnant), and those with a low body mass index (BMI). The low prevalence in elderly patients may be due to a less stretchable dura mater. It is also more common with the use of larger diameter needles. […] PDPH is roughly twice as common in lumbar puncture than spinal anaesthesia, almost certainly due to the atraumatic needles used in spinal anaesthesia.

• #3

  https://sciety.org/articles/activity/10.21203/rs.3.rs-6430476/v1

  Background Spinal anesthesia is the most commonly used anesthesia technique for cesarean section with a prevalence rate of 80% 95%. The most common complications of spinal anesthesia are post-dural puncture headache associated with dural puncture and cerebrospinal fluid leak. […] In our study, the incidence of headache after dural puncture was 3.5%. Studies show that factors such as needle size, number of attempts, body mass index, and anesthesiologist experience are associated with increased incidence of headache. Repeated attempts were observed to increase the likelihood of headache by 1.5 to 4 times. Headache rate was higher when anesthesia was administered by an anesthesia technician than by an anesthesiologist. Our study did not show an association between these factors and headache incidence, which is attributed to the difference in sample sizes studied.

• #3 Post-dural Puncture Headache (PDPH): Symptoms and Treatment

  https://patient.info/treatment-medication/anaesthesia/headache-after-anaesthetic

  Many people have an epidural or spinal injection for surgery or childbirth. A certain type of headache can occasionally develop after an epidural or spinal injection. This is called a post-dural puncture headache (PDPH). […] If too much fluid leaks out through the hole in the dura, the pressure in the rest of the fluid around the brain is reduced. This causes a typical headache, which is called a post-dural puncture headache (PDPH). […] A post-dural puncture headache is often treated with an epidural blood patch. […] The aim is that the blood seals the hole in the dura and stops the leak of fluid. […] If the headache is left untreated, this cushioning is not present and it is occasionally possible for bleeding to occur into or around the brain (a subdural haematoma).

• #3 Spinal Headache

  https://mobile.fpnotebook.com/Neuro/Headache/SpnlHdch.htm

  Orthostatic Headache with CSF Leak or procedure […] Lumbar Puncture with opening pressure of 6 cm H2O […] No other pathologic cause […] Use a small gauge spinal needle (20 to 22) for Lumbar Puncture […] Use non-Traumatic, blunt, non-cutting needle for Lumbar Puncture […] Minimize number of Lumbar Puncture attempts […] Intravenous Fluids prior to Lumbar Puncture […] Does not decrease Spinal Headache Incidence but may decrease duration […] Bedrest for at least 1 hour following Lumbar Puncture does not appear to affect postdural headache Incidence.

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