How to deal with headache after lumbar puncture?

Most occurred within 48 hours after lumbar puncture, usually lasted 2-3 days, and the headache disappeared completely after two weeks at most. The symptoms and treatment of headache are the same as those of intracranial hypotension headache caused by other causes. In order to prevent headache after lumbar puncture, a small needle should be used during puncture, and the rate of fluid discharge should be slow. After lumbar puncture, the patient should lie down or prone for 4-6 hours and give enough fluids. In the event of headache after lumbar puncture, the patient should stay in bed more, walk less, and drink more water, which can generally alleviate the symptoms, and can be cured by intravenous infusion of fluids if necessary. For emergency treatment of headache after lumbar puncture, in addition to pain relief, please consult anesthesiology department and perform Blood Patch. Operated by an anesthesiologist, the patient's own blood (20-30ml) is injected into the epidural space through epidural puncture, and the dural break is sealed in the form of a hematoma, with a success rate of 70%-98%. In addition to blood injection, saline can also be used.

A poster presentation study at the 24th Annual Meeting of the European Association of Neurology found that intravenous theophylline quickly relieved headaches common after a lumbar puncture and reduced mean pain scores by half within 30 minutes of treatment, with no adverse effects. According to the definition of the Headache Classification Committee of the International Headache Society, post-lumbar puncture headache refers to bilateral headache that appears within 7 days of lumbar puncture and disappears within 14 days; it can be aggravated within 15 minutes of standing upright and relieved within 30 minutes of lying down. After dural perforation, cerebrospinal fluid leaks continuously, the volume and pressure of cerebrospinal fluid (CSF) decrease, and headache occurs when the intracranial pain-sensitive structure is distracted in the upright position; at the same time, the decrease of CSF volume will directly stimulate adenosine receptors and make cerebrovascular Dilation, causing headaches after lumbar puncture. Headache symptoms after lumbar puncture are generally a normal reaction. They are caused by low intracranial pressure caused by the leakage of cerebrospinal fluid from the puncture point, and most of them can be relieved by themselves.

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