Headache After Spinal Tap (with Patch)

Illustration of the brain and spinal cord

Spinal fluid fills the space around the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF). CSF is a clear, waterlike fluid that acts like a cushion. During a spinal tap procedure, a needle is passed through the membrane that surrounds the spinal canal. This allows the healthcare provider to remove a small sample of spinal fluid. This fluid provides important information about the health of your brain and spinal cord. Normally, as the needle is removed, the puncture hole seals off and no more fluid comes out. But sometimes the hole doesn't seal correctly and spinal fluid leaks into the nearby tissues.

If there is a loss of too much spinal fluid from a leak at the puncture site, the spinal fluid pressure goes down and a headache occurs (spinal tap headache or post-lumbar puncture headache). This headache may be mild or severe. The pain is often worse when you sit or stand and gets better or goes away when you lie down. You may also have dizziness, nausea, and blurred vision. The headache often goes away within 24 hours. But when the headache is very severe or lasts longer than 24 hours, special treatments can be given to stop the leak.

A leak can be treated with a blood patch. This is done by drawing a sample of your own blood and injecting it next to the puncture hole. This forms a blood clot that presses against the hole to stop the leak and increase the fluid pressure. Most people start to feel better within 30 minutes after the procedure. Improvement usually continues over the next several days. In a small percent of cases, the headache continues or may come back. In that case, a second procedure or another treatment may be needed.

Home care

  • Once you get home, rest lying down for 12 hours.

  • As much as possible, don't sit or stand during the first 12 hours. It's OK to get up to eat and go to the bathroom for short periods of time.

  • Drink extra fluids for the next 24 hours. On a normal day, healthy men should have about 125 ounces (3.7 liters) of total water, from all drinks and food per day. Healthy women should take in about 91 ounces (2.7 liters) of total water, from all drinks and food per day.

  • Caffeine can help this type of headache. Unless told otherwise, you may drink coffee or another caffeinated drink.

  • If you were given medicine for nausea, take it as directed.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to get medical advice

Call your provider right away if any of these occur:

  • Headache remains severe for more than a few hours after the procedure

  • Headache gets worse with sitting or standing

  • Vomiting repeatedly (unable to keep liquids down)

  • Numbness or tingling of the legs

  • Unable to pee

  • Bleeding or pain at the injection site

  • Confusion or trouble thinking

  • Fever 100.4°F (38°C) or whatever your provider told you to report based on your medical condition

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