Materiały źródłowe

• #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 usually go away on their own. But some cases require an epidural blood patch. […] To manage most spinal headaches, healthcare providers recommend: lying down in a flat position, drinking lots of fluids, including drinks containing caffeine (like coffee, tea and some soft drinks), and taking over-the-counter pain relievers (analgesics). […] If a spinal headache lasts more than a few days, your provider may recommend an epidural blood patch. During this procedure, a provider injects a small amount of your blood over the hole that’s leaking CSF. When the blood clots, it seals the hole. […] In rare cases, providers use surgery to seal the hole where spinal fluid is leaking. […] While most spinal headaches go away on their own, you might need an epidural blood patch to treat it.

• #2 Spinal Headaches: What Are the Symptoms and Is There a Gold Standard of Treatment?

  https://www.treatingpain.com/news-updates/2019/may/spinal-headaches-what-are-the-symptoms-and-is-th/

  Spinal headaches, also known as postdural puncture headaches, are intense headaches caused by a leak of cerebrospinal fluid (CSF), the protective liquid surrounding your brain and spinal cord. […] The goal of treatment is to restore pressure and replenish cerebrospinal fluid. Treatment options can be divided into both conservative and minimally invasive. […] The gold standard of treatment for persistent spinal headaches is an epidural blood patch (EBP). This minimally invasive procedure involves injecting a small amount of your own blood into the epidural space around your spinal cord, sealing the CSF leak, and relieving the pressure headache. An epidural blood patch is a safe and effective procedure used to treat spinal headaches and has been employed since the 1960s; it is still considered the standard of care for postdural puncture headaches. […] Supportive care involves rehydration and analgesics (acetaminophen, nonsteroidal anti-inflammatory drugs, antidepressants, antiepileptics, local anesthetics, and opioids). […] Caffeine can also help reduce headache severity.

• #3 Spinal headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-headaches/diagnosis-treatment/drc-20377917

  Treatment for spinal headaches begins conservatively. Your provider may recommend getting bed rest, drinking plenty of fluids, consuming caffeine and taking oral pain relievers. […] If your headache hasn’t improved within 24 hours, your provider might suggest an epidural blood patch. Injecting a small amount of your blood into the space over the puncture hole will often form a clot to seal the hole, restoring normal pressure in the spinal fluid and relieving your headache. This is the usual treatment for persistent spinal headaches that don’t resolve on their own.

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

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

  Most spinal headaches also known as post-dural puncture headaches resolve on their own with no treatment. However, severe spinal headaches lasting 24 hours or more may need treatment. […] Treatment for spinal headaches begins conservatively. Your provider may recommend getting bed rest, drinking plenty of fluids, consuming caffeine and taking oral pain relievers. […] If your headache hasn’t improved within 24 hours, your provider might suggest an epidural blood patch. Injecting a small amount of your blood into the space over the puncture hole will often form a clot to seal the hole, restoring normal pressure in the spinal fluid and relieving your headache. This is the usual treatment for persistent spinal headaches that don’t resolve on their own.

• #5 Learning About Spinal Headaches | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-spinal-headaches.acd7517

  A mild spinal headache can be relieved by self-care at home. It usually goes away in a few days. A good first step is to lie down in a quiet, dark room until the headache is gone. […] Your doctor may also suggest caffeine to relieve your headache. If your doctor agrees, you can take over-the-counter pain medicine. Be sure to follow the directions on the label. […] If your home treatment doesn’t relieve the headache, talk to your doctor about getting treated with a blood patch. This procedure uses your own blood to help your headache. […] To apply a blood patch, your doctor takes blood from your arm and injects it into the area of your lower back where the leak happened. The blood restores the pressure around your spinal cord. It also helps seal any leak that may still be there. […] Many people feel better right away, but it could take a day or two. And a few people need to have a second blood patch. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #6 Lumbar Puncture Headache: Your Questions Answered

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

  According to a 2016 research review, oral or intravenous (IV) caffeine may help stimulate CSF production, causing a reduction in symptoms. […] A doctor will likely encourage you to lie down as much as possible until your headache improves. […] They may also recommend over-the-counter (OTC) pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil). […] A lumbar puncture headache is a common side effect after undergoing a spinal tap procedure. […] Most lumbar puncture headaches resolve on their own within a few days as your puncture heals. […] During this time, its important to rest and use OTC pain relievers as a doctor recommends.

• #7 Spinal Headaches from Epidural or Lumbar Puncture

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

  How Are Spinal Headaches Treated? […] If the headache requires treatment, it could involve: […] Hydration: This can help raise cerebral spinal fluid (CSF) pressure. You might need to get fluids through your veins (the doctor will call these intravenous fluids, or IV for short). […] Caffeine: The doctor might tell you to drink a beverage high in caffeine. […] Bed rest: You may have to take it easy for 24-48 hours. […] Medication: If other methods dont work, your doctor could try drugs like gabapentin, hydrocortisone, or theophylline. […] Blood patch: If you get a spinal headache after a procedure, the anesthesiologist can create a patch with your blood to seal the leak. To put the blood patch in place, the anesthesiologist will put a needle into the same space as, or right next to, the area where the anesthetic was injected. Next, theyll take a small amount of your blood and inject it into the epidural space. The blood clots and seals the hole that caused the leak.

• #8 5 Options for Spinal Headache Treatment | SSOR

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

  A spinal headache, also known as a post-dural puncture headache, is a type of headache that can happen after a lumbar puncture or spinal tap. Various treatment options are available that can help manage and alleviate the symptoms of this kind of headache. […] Treatment options can include: […] Increasing your fluid intake is important to help boost your cerebral spinal fluid pressure. […] Your doctor may suggest you have a caffeine-rich drink. […] Its crucial to take it easy and allow your body to rest. […] Over-the-counter pain relievers and medications designed to help with headaches can be taken to help alleviate the symptoms of a spinal headache. […] In cases where a spinal headache doesnt resolve on its own or with the help of other conservative measures, your health care provider may recommend a blood patch. A blood patch uses your blood to create the patch. […] Recovering from a spinal headache caused by a lumbar puncture or epidural anesthesia involves a gradual and personalized approach. Our team at SSOR can help address any lingering discomfort, restore your mobility, and help support your overall spinal health and well-being.

• #9 Drugs for treating headache after a lumbar puncture | Cochrane

  https://www.cochrane.org/CD007887/SYMPT_drugs-treating-headache-after-lumbar-puncture

  Lumbar puncture involves getting a sample of spinal fluid though a needle inserted into the lower back. Post-dural puncture headache (PDPH) is the most common side effect of a lumbar puncture. The symptom of PDPH is a constant headache that gets worse when upright and improves when lying down. Lots of drugs are used to treat PDPH, so the aim of this review was to assess the effectiveness of these drugs. […] Caffeine proved to be effective in decreasing the number of people with PDPH and those requiring extra drugs (2 or 3 in 10 with caffeine compared to 9 in 10 with placebo). Gabapentin, theophylline and hydrocortisone also proved to be effective, relieving pain better than placebo or conventional treatment alone. More people had better pain relief with theophylline (9 in 10 with theophylline compared to 4 in 10 with conventional treatment).

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

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

  Spinal headaches may be painful, even disruptive while they occur, but they are typically not a serious health concern. That is why most physicians will recommend conservative treatment options rather than more risky therapies. […] There is still ongoing debate as to the efficacy of some of the following therapies, but these are the most common treatments for spinal headaches recommended by clinicians. […] Your physician may recommend that you merely rest for a few days to see if symptoms subside. […] Most medical experts recommend that you drink plenty of fluids following your surgery to assist your body in the production of CSF. […] For many patients, the headache symptoms are mild enough that they can be treated with over-the-counter medications like aspirin, acetaminophen (Tylenol) or ibuprofen (Motrin).

• #11

  https://www.mountelizabeth.com.sg/conditions-diseases/spinal-headache/diagnosis-treatment

  Treatment for a spinal headache focuses on relieving symptoms and addressing the underlying cause: […] Bed rest, specifically lying flat with your head elevated, can help minimise cerebrospinal fluid leakage and promote healing of the puncture site. […] Hydration with fluids, including caffeinated beverages, may help constrict blood vessels and alleviate symptoms. […] Pain relief: Using pain relievers such as ibuprofen or acetaminophen. […] Caffeine tablets/solutions are used to improve production of spinal fluid from the brain. […] Epidural blood patch procedure, which is a minimally invasive procedure involving injecting a small amount of your own blood into the epidural space near the puncture site to seal the cerebrospinal fluid leak and promote healing, if the headache persists. […] Intravenous (IV) fluids and medications to manage pain and nausea may be necessary.

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

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

  70% of people who use an epidural blood patch get rid of their spinal headache pretty quickly. Those who do not improve may require a second blood patch or even specialized stitches. […] In rare cases, a doctor may utilize surgical glue or stitches to patch up the tiny hole in your spinal cord. This is usually only considered if a blood patch could not fix your spinal headache. […] Several dietary supplements can help you deal with the headache pain. These don’t treat the root cause of your spinal headache, but pain relief is often a powerful asset. […] Chiropractic care may help to regulate cerebrospinal fluid levels and prevent headache symptoms. Consider seeing a chiropractor if you experience persistent headaches.

• #13 Post Lumbar Puncture Headaches – REBEL EM – Emergency Medicine Blog

  https://rebelem.com/post-lumbar-puncture-headaches/

  Post lumbar puncture (LP) headache is one of the most common complications from LPs (6 36% incidence) and is essentially a clinical diagnosis based on a history of a dural puncture and the postural nature of the headache with associated symptoms. […] In terms of the prevention and treatment of post-LP headaches, both are equally important in management. […] Needle size must however be large enough to withdraw fluid safely, efficiently, and measure accurate opening pressures. […] Conclusion: Parallel direction of needle bevel does decrease incidence of post LP headache. […] Conclusion: Replacement of stylet before spinal needle withdrawal, decreases incidence of post LP headache. […] Conclusion: There is no difference in post LP headache incidence with early ambulation vs bed rest after LP.

• #14 Drug therapy for treating post‐dural puncture headache

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6457875/

  Postdural puncture headache (PDPH) is the most common complication of lumbar puncture, an invasive procedure frequently performed in the emergency room. Numerous pharmaceutical drugs have been proposed to treat PDPH but there are still some uncertainties about their clinical effectiveness. […] To assess the effectiveness and safety of drugs for treating PDPH in adults and children. […] We included 13 small RCTs (479 participants) in this review (at least 274 participants were women, with 118 parturients after a lumbar puncture for regional anaesthesia). […] Pharmacological drugs assessed were oral and intravenous caffeine, subcutaneous sumatriptan, oral gabapentin, oral pregabalin, oral theophylline, intravenous hydrocortisone, intravenous cosyntropin and intramuscular adrenocorticotropic hormone (ACTH).

• #15 Drug therapy for treating post‐dural puncture headache

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6457875/

  Caffeine reduced the number of participants with PDPH at one to two hours when compared to placebo. Treatment with caffeine also decreased the need for a conservative supplementary therapeutic option. […] Treatment with gabapentin resulted in better visual analogue scale (VAS) scores after one, two, three and four days when compared with placebo and also when compared with ergotamine plus caffeine at two, three and four days. […] Treatment with hydrocortisone plus conventional treatment showed better VAS scores at six, 24 and 48 hours when compared with conventional treatment alone and also when compared with placebo. […] Treatment with theophylline showed better VAS scores compared with acetaminophen at two, six and 12 hours and also compared with conservative treatment at eight, 16 and 24 hours.

• #16 Drugs for treating headache after a lumbar puncture | Cochrane

  https://www.cochrane.org/CD007887/SYMPT_drugs-treating-headache-after-lumbar-puncture

  Caffeine has shown effectiveness for treating PDPH, decreasing the proportion of participants with PDPH persistence and those requiring supplementary interventions, when compared with placebo. Gabapentin, hydrocortisone and theophylline have been shown to decrease pain severity scores. Theophylline has also been shown to increase the proportion of participants that report an improvement in pain scores when compared with conventional treatment. […] There is a lack of conclusive evidence for the other drugs assessed (sumatriptan, adrenocorticotropic hormone, pregabalin and cosyntropin). […] Caffeine reduced the number of participants with PDPH at one to two hours when compared to placebo. Treatment with caffeine also decreased the need for a conservative supplementary therapeutic option.

• #17 Drugs for treating headache after a lumbar puncture | Cochrane

  https://www.cochrane.org/CD007887/SYMPT_drugs-treating-headache-after-lumbar-puncture

  Treatment with gabapentin resulted in better visual analogue scale (VAS) scores after one, two, three and four days when compared with placebo and also when compared with ergotamine plus caffeine at two, three and four days. Treatment with hydrocortisone plus conventional treatment showed better VAS scores at six, 24 and 48 hours when compared with conventional treatment alone and also when compared with placebo. Treatment with theophylline showed better VAS scores compared with acetaminophen at two, six and 12 hours and also compared with conservative treatment at eight, 16 and 24 hours. Theophylline also showed a lower mean „sum of pain” when compared with placebo. […] Theophylline resulted in a higher proportion of participants reporting an improvement in pain scores when compared with conservative treatment. […] There were no clinically significant drug adverse events.

• #18 Drug therapy for treating post‐dural puncture headache

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6457875/

  Theophylline resulted in a higher proportion of participants reporting an improvement in pain scores when compared with conservative treatment. […] None of the new included studies have provided additional information to change the conclusions of the last published version of the original Cochrane review. Caffeine has shown effectiveness for treating PDPH, decreasing the proportion of participants with PDPH persistence and those requiring supplementary interventions, when compared with placebo. Gabapentin, hydrocortisone and theophylline have been shown to decrease pain severity scores. […] There is a lack of conclusive evidence for the other drugs assessed (sumatriptan, adrenocorticotropic hormone, pregabalin and cosyntropin). […] The variability of symptoms makes PDPH a diagnosis of exclusion. Other alternative diagnoses should be ruled out (e.g. viral meningitis, sinus headache or intracranial haemorrhage).

• #19 The Efficiency of Intravenous Theophylline on the Headache Which Occurs After Spinal Anesthesia | Akdere | Journal of Neurology Research

  https://www.neurores.org/index.php/neurores/article/view/78/73

  The treatment of the headache occurring after spinal anesthesia through pharmacological medication is a minimally invasive treatment. […] The treatment consists of abundant hydration, oral analgesics, caffeine, theophylline, bed rest and stomach corset. As the last option, blood patch is used by injecting the patients own blood (10 mL) taken in a sterile way via the epidural. […] The treatment of the headache occurring after spinal anesthesia with medication is a less invasive method when compared to the blood patch technique. […] Our findings suggest that the use of teophylline infusion is effective and quick in the treatment of headache occurring after spinal anesthesia. Along with that, this treatment is preferable for being an easy, fast and minimally invasive.

• #20 Post-dural-puncture headache – Wikipedia

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

  PDPH is a common side effect of lumbar puncture and spinal anesthesia. […] Morphine, cosyntropin, and aminophylline appear effective in reducing post dural puncture headaches. […] Some people require no other treatment than pain medications and bed rest. A 2015 review found tentative evidence to support the use of caffeine. […] Pharmacological treatments as; gabapentin, pregabalin, neostigmine/atropine, methylxanthines, and triptans. […] Persistent and severe PDPH may require an epidural blood patch. A small amount of the person’s blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then „patches” the meningeal leak. […] EBP is effective, and further intervention is rarely necessary.

• #21 Postdural Puncture Headache – StatPearls – NCBI Bookshelf

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

  The initial management of PDPH symptoms involves administering analgesics, oral or intravenous hydration, and avoiding having the patient in the upright position. This approach is often effective. In over two-thirds of patients, PDPH symptoms can resolve spontaneously within 1 to 2 weeks. However, therapeutic intervention is required when severe symptoms are persistent. […] Definitive treatment by administering an epidural blood patch is usually recommended when symptoms persist after conservative treatment has failed. […] For this procedure, 10 mL to 30 mL of autologous venous blood is injected by an anesthesiologist into the epidural space at the spinal level where the catheter was previously placed to administer anesthesia during the delivery. […] Due to the high success rates and low complication rates of the epidural blood patch, it remains the primary therapy for PDPH.

• #22 Epidural Blood Patch: What It Is, Procedure & Complications

  https://my.clevelandclinic.org/health/procedures/epidural-blood-patch

  An epidural blood patch (EBP) is a procedure that uses an injection of your blood to stop a cerebrospinal fluid (CSF) leak near your spinal cord. It can treat spinal headaches, which can develop after procedures like spinal taps and epidurals. […] Providers offer this procedure to help treat spinal headaches (post-dural puncture headaches). An EBP has two functions: It seals the puncture site or tear by forming a temporary blood clot. It reduces low CSF pressure. […] Epidural blood patch procedures are often successful at treating a spinal headache, but they dont work in some cases. […] Your healthcare provider may recommend an EBP if you develop a spinal headache and conservative treatment doesnt help. […] Most people feel immediate headache relief after getting an epidural blood patch.

• #23 Postdural Puncture Headache – NYSORA

  https://www.nysora.com/topics/complications/postdural-puncture-headache/

  The mechanism of action of the EBP, while not entirely elucidated, appears to be related to the ability to stop further CSF loss by the formation of clot over the defect in the meninges as well as a tamponade effect with cephalad displacement of CSF. […] The appropriate role of the EBP in individual situations will depend on multiple factors, including the duration and severity of headache and associated symptoms, type and gauge of original needle used, and patient wishes. […] The EBP should be encouraged in patients experiencing ADP with an epidural needle and those whose symptoms are categorized as severe (ie, pain score > 6 on a 1–10 scale). […] Informed consent for the EBP should include a discussion with the patient regarding the common as well as serious risks involved, true success rate, and anticipated side effects.

• #24 Epidural Blood Patch: What It Is, Procedure & Complications

  https://my.clevelandclinic.org/health/procedures/epidural-blood-patch

  EBPs usually provide immediate and prolonged spinal headache relief, whereas conservative treatments, like NSAIDs and caffeine, are typically temporary. Spinal headaches can last up to two weeks, so EBPs can offer quicker relief. […] Studies show that epidural blood patches have a success rate of about 85%. That means about 85 out of 100 procedures result in spinal headache relief. […] Yes. Epidural blood patch procedures arent always successful. You may still have a spinal headache despite undergoing the procedure. But this is uncommon. A second procedure treats the headache in 90% of these cases. […] A note from Cleveland Clinic: When you have a throbbing spinal headache that only gets better when youre lying down, youll probably want quick relief. An epidural blood patch may be able to offer that. Be sure to discuss the risks and benefits of an EBP with a healthcare provider before deciding to get one and know that the patches arent always successful.

• #25 Spinal Headache – Obstetrical Anesthesia Associates

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

  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. […] Medications such as caffeine (in IV or pill form) or sumatriptan (Imitrex) have been shown to help improve headache symptoms but have not been fully evaluated. 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. […] Epidural blood patches are remarkably effective with 75% of people getting complete relief of symptoms, 18% getting partial relief, and only 7% getting no relief. This procedure involves the same risks as a labor epidural and you will probably experience some back discomfort during the procedure and for a few hours after the procedure. […] Occasionally a spinal headache will return after a successful blood patch. We think this happens if the platelet cork is displaced from the hole in the spinal sac. If the headache is severe, a repeat blood patch is usually offered.

• #26 Lumbar Puncture Headache: Your Questions Answered

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

  Post-dural puncture headaches often develop within a few days of a lumbar puncture (spinal tap). […] If they persist, a doctor might recommend an epidural blood patch. […] A lumbar puncture headache usually improves on its own without medical intervention. […] But doctors may treat severe cases with an epidural blood patch. This procedure involves taking a small sample of your own blood and injecting it into your lower back. The purpose is to form a blood clot to close the hole and stop the spinal leakage. […] Various studies estimate that a blood patch improved peoples conditions 61% to 98% of the time. […] According to a 2020 review, its typical for people to experience immediate pain relief after a blood patch. […] Depending on your tolerance, a doctor may recommend caffeine.

• #27 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

  Treatment of PDPH with an EBP was first described by Gormley in 1960. […] Blood patches placed after an initial observation period of greater than 24 hours have a higher success rate approaching 93% after one EBP and 97% after a second EBP. […] Women should be informed that performing an EBP within 48 hours of dural puncture is associated with a reduction in its efficacy and a greater requirement for a repeat EBP. […] In cases of partial or no relief, a second EBP may be performed after consideration of other causes of headache. […] If two EBPs have failed to relieve symptoms, other causes of headache must be considered, and involvement of other specialties is recommended before performing a third EBP. […] Prophylactic Epidural Blood Patch (PEBP) Up to 20 ml of blood is injected into the epidural space before catheter removal.

• #28 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

  The success rate of the PEBP is not as high as the TEBP, and may not prevent development of a PDPH, but may reduce the length and severity of symptoms. […] There is currently insufficient evidence to recommend the use of acupuncture, greater occipital nerve blocks, sphenopalatine ganglion blocks, epidural morphine, and prophylactic intrathecal morphine via an intrathecal catheter after UDP in the treatment of obstetric PDPH. […] Complete relief of symptoms following a single epidural blood patch is likely to occur in up to one third of cases, with complete or partial relief seen in 50-80%. […] Back pain during and for several days after EBP is common and can be significant. […] Before performing an EBP, written information should be offered to women to aid the consent process. […] Immediately after an EBP, the patient should be kept in the supine position for up to 1-2 hours for best results. […] Following discharge from the hospital, all women who experience a recognized dural puncture with an epidural needle or have a PDPH diagnosed require follow-up, regardless of whether an EBP is performed.

• #29 How to Cope with a Spinal Headache: 14 Steps (with Pictures)

  https://www.wikihow.com/Cope-with-a-Spinal-Headache

  Spinal headaches occur in up to 40 percent of people who undergo a spinal tap or spinal anesthesia. Most spinal headaches go away on their own with no treatment. If your spinal headache lasts longer than 24 hours, you can take steps to address it at home, or visit the doctor to treat severe, chronic headache. […] If your headache does not resolve within 24 hours, despite taking steps mentioned above, get an epidural blood patch. During an epidural blood patch procedure, a small amount of your own blood will be injected in the space just outside the perforation in your spine. The blood will clot, sealing the perforation and restoring pressure in the spinal membrane. This restores spinal pressure and stops further leakage, relieving headache symptoms. […] A saline solution such can be injected into the epidural space instead of blood. It produces a similar effect as blood, but is sterile and comes with a much lower risk of infection. […] Surgery is the last treatment option for spinal headache. When all other measures fail to stop a spinal leak, surgery can be attempted to repair the perforation. It immediately stops the CSF leak, but carries the risk of infection and is somewhat invasive.

• #30 What Clinicians Must Know About Lumbar Puncture Headaches

  https://hospitalprocedures.org/what-clinicians-must-know-about-lumbar-puncture-headaches/

  Efficient pain management is thus the only option for these patients if an epidural blood patch treatment is not a possibility. […] In such situations, caffeine is often recommended as it can help stimulate the production of cerebrospinal fluid, thus reducing the headache. Caffeine also decreases dilated blood vessels in the brain because of its ability to act as a vasoconstrictor, which can help relieve pain. […] Over-the-counter medications to reduce pain are also excellent options for patients who cannot undergo epidural blood patches. This includes acetaminophen such as Tylenol, or ibuprofen like Advil. […] Proper hydration is also important as it reduces the amount of cerebrospinal fluid leakage, or increases the volume of the cerebrospinal fluid. Patients must thus be advised to drink plenty of fluids after their spinal tap procedure to help relieve their headaches.

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

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

  Although it is not well understood why, caffeine may offer some pain relief for spinal headaches. […] This is a more aggressive form of spinal headache treatment that involves injection of the patients own blood into the spinal canal. […] Some researchers have attempted using saline or dextran 40 instead of a patients blood. […] If all others prove unsuccessful, then your physician may opt for a surgical remedy.

• #32 Post Dural Puncture Headache After Spinal Cord Stimulator Lead Insertion Successfully Treated with Occipital Nerve Blocks | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/124339-post-dural-puncture-headache-after-spinal-cord-stimulator-lead-insertion-successfully-treated-with-occipital-nerve-blocks

  Post-dural puncture headache (PDPH) is a common and debilitating complication that can arise after spinal or epidural anesthesia, or following the placement of spinal cord stimulation leads due to inadvertent dural puncture. […] Given the failure of the EBP, she was treated with bilateral occipital nerve blocks, which resulted in near-complete and rapid resolution of her symptoms. This case highlights the effectiveness of occipital nerve blocks as a therapeutic option for PDPH, especially in challenging cases where other treatments have proven inadequate. […] Treatment options for PDPH may include a trial of conservative management, such as increased fluid intake and hydration, caffeine, and oral analgesics. If conservative options fail to alleviate symptoms, an epidural blood patch (EBP) is commonly performed.

• #33 Post Dural Puncture Headache After Spinal Cord Stimulator Lead Insertion Successfully Treated with Occipital Nerve Blocks | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/124339-post-dural-puncture-headache-after-spinal-cord-stimulator-lead-insertion-successfully-treated-with-occipital-nerve-blocks

  In recent years, peripheral nerve blocks, particularly occipital nerve blocks, have gained attention as a viable alternative or adjunctive treatment for PDPH. […] The goal of occipital nerve blocks is to block the transmission of pain signals from the occipital nerves, thereby reducing pain and discomfort. […] The success of occipital nerve blocks in this case aligns with the literature. […] This outcome underscores the efficacy of occipital nerve blocks not only as a primary treatment in refractory cases of PDPH but also as a rescue therapy following a failed EBP. […] This case report illustrates the potential of occipital nerve blocks as an effective treatment for PDPH, particularly in cases where conventional therapies like epidural blood patches fail.

• #34 How Are Lumbar Puncture Headaches Prevented and Treated?

  https://www.brainandlife.org/articles/how-are-lumbar-puncture-headaches-prevented-and-treated

  Up to 30 percent of patients experience a headache after a lumbar puncture (also known as a spinal tap), a procedure that involves inserting a small needle into the membrane around the spinal cord at the lower back to draw out cerebrospinal fluid. […] The best way to prevent a headache is for the doctor to use what’s known as an atraumatic needle, which is less likely to allow spinal fluid to leak. […] If you experience a headache after a lumbar puncture, tell your doctor immediately as he or she may prescribe oral painkillers. […] If the headache persists, patients may benefit from bed rest, fluids, and intravenous caffeine. […] If the headache worsens, neurologists may perform epidural blood patching, a procedure that involves drawing blood from the patient’s arm and injecting it into the spinal canal outside the dura in the lower back. […] If the headache still doesn’t resolve, doctors may use a type of surgical glue to patch the hole where fluid is leaking or close the hole surgically with stitches or other material.

• #35 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. […] Through this activity, participants will learn about the natural course of the condition, appropriate diagnostic approaches, and the spectrum of treatment options, ranging from conservative measures to more invasive interventions (eg, epidural blood patch) for severe cases. […] Diagnosis is primarily clinical, with imaging reserved for atypical or persistent cases. Management approaches comprise conservative measures initially, including hydration, caffeine, and analgesics, and invasive interventions, such as EBP, for more severe symptoms.

• #36

  https://continentalhospitals.com/diseases/spinal-headaches/

  Additionally, certain medications may be prescribed by healthcare professionals to manage symptoms associated with spinal headaches. These medications can include anti-nausea drugs, muscle relaxants, or prescription pain relievers. […] While it is not always possible to prevent spinal headaches entirely, certain precautions can reduce the risk. These include proper positioning during spinal procedures, using smaller-sized needles, and ensuring adequate hydration before and after the procedure.

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

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

  Spinal Headache: Causes, Prevention, Treatment Complications […] 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. […] Learn the ins and outs of spinal headaches, including causes, symptoms, and treatment options. Then, you can be prepared if you ever wake up with spinal headache. […] 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. […] How can I prevent getting a spinal headache? When a doctor performs a spinal tap, they can prevent spinal headaches by opting for a smaller, blunt-tipped spinal needle called a non-cutting needle or atraumatic needle.

• #38 Spinal Headaches, Lumbar Puncture Headache, Prevention and Treatment – Emergency Care Services | No Wait Open 24 HRS

  https://postoaker.com/how-are-lumbar-puncture-headaches-prevented-and-treated/

  Your doctor may recommend bed rest for a few days to alleviate symptoms and create a situation where the hole may spontaneously close. […] Caffeine may help validate solidated cerebral vessels and ease headaches. […] Your doctor may use an epidural blood patch to seal up the hole. An epidural patch is created using a needle to take a small amount of blood from your skin and inject it into the epidural space. The blood forms a clot and seals the site of leakage. […] Medication is often administered if all other procedures fail to treat a spinal headache. Your doctor may prescribe medication such as hydrocortisone or theophylline to ease discomfort. […] In rare cases, you may require surgery to seal up the leakage site. While recovering from a spinal headache, it is crucial to avoid strenuous activities for at least a week. […] Your doctor can minimize the risk of causing a post-lumbar puncture headache by using a non-cutting needle for the procedure.

• #39 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

  Preventing spinal headaches involves taking precautions during spinal procedures to minimize the risk of CSF leakage. This includes using the smallest possible needle, avoiding multiple attempts at needle insertion, and ensuring that the needle is properly inserted and removed. Additionally, staying well-hydrated before and after the procedure can help maintain normal CSF pressure and reduce the risk of developing a spinal headache. […] Knowledge of symptoms, causes, and treatments is vital for both healthcare providers and patients. Precautionary measures and timely treatment mitigate risks and alleviate symptoms effectively. […] Spinal headaches result from a decrease in CSF pressure caused by fluid leakage during procedures involving needle insertion into the spinal canal. Risk factors include pregnancy, a history of migraines, and connective tissue disorders. Needle size and technique also play a role in the likelihood of developing this condition.

• #40 Postdural Puncture Headache – NYSORA

  https://www.nysora.com/topics/complications/postdural-puncture-headache/

  Postural headaches following interventions that disrupt meningeal integrity are most commonly labeled postdural puncture headaches (PDPHs). […] The EBP, a startlingly unique medical procedure, proved to be the major breakthrough in the treatment of PDPH. […] Today, the EBP is nearly universally employed as the cornerstone for treatment for severe PDPH. […] The practical significance of PDPH is illustrated by notation in the American Society of Anesthesiologists Closed Claims Project database as one of the most frequent claims for malpractice involving obstetric anesthesia, regional anesthesia, and chronic pain management. […] The potentially serious nature of this complication necessitates inclusion in informed consent involving any procedure that may result in PDPH. […] The EBP has emerged as the “gold standard” for treatment of PDPH.

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

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

  Spinal Headache Treatments […] Doctors typically start with the least invasive methods before considering more aggressive treatments. […] Conservative Treatment Approaches: The initial treatment plan focuses on simple, non-invasive methods patients can implement at home. Doctors recommend several key strategies: Maintaining a flat lying position for at least 24-48 hours […] Increasing fluid intake significantly […] Consuming caffeine-rich beverages […] Taking over-the-counter pain relievers. […] Invasive Treatment Approaches: Doctors may recommend more targeted interventions if these conservative measures don’t provide relief within 24 hours. The most effective treatment for persistent spinal headaches is an epidural blood patch. In rare instances where the epidural blood patch proves ineffective, surgical intervention might be necessary to seal the spinal fluid leak.

• #42 Spinal Headaches Treatment in NYC & NJ | Advanced Headache Center

  https://www.advancedheadachecenter.com/headaches/spinal-headaches

  Spinal headaches are painful episodes, but theyre caused by an underlying medical condition that can often be treated. […] Instead of self-medicating with over-the-counter painkillers, visit a headache specialist like Dr. Amr Hosny at the Advanced Headache Center, with eight offices from New York City to Paramus, New Jersey. […] To get the most effective spinal headache treatment, you need an early diagnosis. […] After diagnosing a spinal headache, he develops a personalized treatment plan designed for your particular case. […] You can get spinal headache treatment and manage these headaches effectively. […] Dr. Hosny may recommend conservative treatment options first, including: Drinking plenty of fluids, Consuming caffeine, Taking over-the-counter pain relievers. […] Advanced treatments may include an epidural blood patch to seal the spinal cord fluid leak, epidural non-blood injections, or surgical intervention. […] The goal is to address the underlying injury or illness thats causing your spinal headaches. […] Contact the nearest headache specialists at the Advanced Headache Center. […] Get the best treatment for your spinal headaches to achieve a better quality of life.

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