Post spinal headache true is
Ans. (b) Better with caffeine(Ref: Postgrad Med). 2006 Nov; 82 (973): 713-716.)Post spinal headache:* Post spinal headache is defined as "bilateral headaches that develop within 7 days after an lumbar puncture and disappears within 14 days* Headache after lumbar puncture occurs more often in young adults, especially in the 18-30-year age group.* Young women with a lower body mass index and those who are pregnant have the highest risk of developing headaches after lumbar puncture.* 1/3rd of the patient develop spinal headache.* Usually occurs after 24-48 hours of Spinal injection.* Spinal headache depends on the size of needle used, Number of attempts used to puncture, direction and design of the bevel in needle etc* The most important cause for headache is not the pressure in the CSF but the volume of fluid leaking.* The headache worsens within 15 min of resuming the upright position, disappears or improves within 30 min of resuming the recumbent positionManagement:* Conservatively more than 85% cases are cured.* Supporting treatment such as rehydration, simple analgesics, opioids and anti-emetics may control the symptoms in milder cases.* Epidural patch closure, Caffeine, Epidural Hypertonic Saline or Dextran injection are used.* Increased oral fluids is found recently as no benefit in the reduction of symptoms.
Not become better on recumbent
Better with caffeine
More pressure dependent than volume
Starts immediately
Nervous System