Myths and Facts on Managing Headaches after a Lumbar Puncture

Posted by on Feb. 05, 2013

What is lumbar puncture?
Lumbar puncture, or spinal tap, is done most often to determine whether a patient has meningitis. In a usual procedure, the doctor inserts a very thin needle into the space between two lumbar vertebrae and withdraws a few drops of cerebro-spinal fluid (CSF), which is sent for analysis. Though the process sounds quite painful, the aftereffects can be much more painful.

About a third of patients who endure a lumbar puncture develop severe headaches within hours of the procedure. A much smaller number encounter headaches a few days after. The pain is persistent and somewhat debilitating. It is believed that a headache develops if CSF continues to leak out of the puncture after the procedure, thereby reducing the total volume of the fluid. Loss of volume causes pain to the patient.

Headache Treatment Facts
One of the more intrusive remedies is aimed at stopping the leakage by injecting the patient’s own blood into the space where the puncture took place. The blood clots inside the area and prevents further leakage. Usually, though, the symptoms abate on their own with the aid of mild pain killers.

Headache Prevention Myths
Until the 1980s, health care practitioners held a number of beliefs about headaches developed after a lumbar puncture that were subsequently proven false. One belief was that the headache could be prevented by having the patient lay flat for two hours after the procedure. Another belief on headache prevention was fluid intake after the procedure. The thought was that the body used this fluid to create new CSF, but recent studies found no evidence to back this up. A third belief was that the volume of fluid removed determined whether a headache would develop. They also thought that a certain amount of bed rest after lumbar puncture would prevent headaches. Finally, there was the belief that the position of the patient during the procedure had an impact that triggered the headaches.

Most people experience abatement of their headaches within a short period of time and with no interventions after undergoing this procedure.

[Photo Credit: James Heilman, MD (Own work) [CC-BY-3.0], via Wikimedia Commons]

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