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How Long Do Post-lumbar Puncture Headaches Last?

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Posted on Tue, 15 Dec 2015
Question: HAD ANOTHER BLOOD PATCH THIS MORNING-STILL HAVING SYMPTOMS OF LUMBAR PUNTURE HEADACHES FROM 9 1/2 WEEKS AGO. THOUGHT I WOULD GET RELIEF FROM HEADACHES,BUT ACTUALLY HEADACHES ARE WORSE. IS THERE A SENARIO THAT A BP COULD MAKE YOU FEEL WORSE SYMPTOMS RATHER THAN BETTER.
doctor
Answered by Dr. Luchuo Engelbert Bain (7 hours later)
Brief Answer:
Blood patch is satisfactory in most patients. Cautious waiting and 2nd opin

Detailed Answer:
Hi and thanks for the query,

It is true that most lumbar tap headaches should fade out before the 9th week. However, it is not rare to see these headaches persist in some persons for over 16 weeks. The most important however is the evolution of the headache intensity. It is reassuring in case the intensity of the headaches do decrease as time goes on (even if they do persist). A headache of stable intensity of headaches that even get worse with time would require the opinion of your doctor to check for other possible complications (infection, brain oedema) that could be associated with the procedure.

It is rare for a blood patch to make one feel worse, especially if the procedure is well indicated and performed appropriately. Over 90% of patients who undergo this procedure generally feel better.

I would suggest patience, but being watchful. You might have to see your doctor again in case the symptoms do persist or aggravate. In case the feeling is stable or getting worse, a complete clinical review and a second opinion should be sought.

Kind regards as I wish you the best of health.

Dr Bain
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Luchuo Engelbert Bain (3 days later)
I had a follow up Lumbar MRI yesterday, and it did not show any type of Epidural Hematoma, or Abscess from the Blood Patch procedure. I am still having more intense LP headaches since the BP on Monday, but the doctor who did the procedure was very confident that was no new Dura tear initiated as a result of the Blood Patch. I have had back ,buttock, and leg pain(mostly in knee area), along with some numbness in my hand, and tingling, swollen feeling, numbness and itchiness in my right foot, although these symptoms seem to be quieting down in the last 24 hours. I do not have a fever , but I do have some chills and night sweating-I am wondering if I have a possible infection from the BP procedure(I know it is pretty rare, and there doesn't appear to be any redness around the incision area). Please reply back with your thoughts. I know that some of these symptom could be as a result of my Lyme disease(especially the sweating).

Regards,

XXXX
doctor
Answered by Dr. Luchuo Engelbert Bain (11 minutes later)
Brief Answer:
Patience, simple analgesics, complete blood count, CrP, procalcitonine meas

Detailed Answer:
Hi and thanks for the query
There is a possibility of an infection with the procedure,especially if the antisepsis principles are not properly applied , but these are rare as you pointed out.

Doing a complete blood count and measuring c reactive protein levels or if possible , procalcitonin levels could indirectly tell us if there is an infection or not. I do however think it's somehow early to do these.

I suggest patience and use of simple analgesics like acetaminophen for a couple of days.

in case symptoms persist or aggravate, possibility of an infection will be sought.

I strongly suggest symptomatic treatment and remaining watchful . it's still relatively early to be too worried.

Kind regards

Dr Bain

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Luchuo Engelbert Bain (3 days later)
Doc-thanks for getting back to me so quickly-your answers have been quite helpful. I am getting very frustrated, because the 2nd blood patch was supposed to relief the headaches, but in fact I am feeling worse. Headaches are still prevalent, and I am feeling pretty despondent. I spoke to my neurologist and he says I need to continue to rest-lie flat on my back, and the headaches should get better. Also, the pain is still there in my right lower back, buttock, and leg(especially the calf area). My right foot is sore , and feels swollen and tingly with some numbness(those are new symptoms since the BP last week)..The doctor who performed the BP said that it is the nerves reacting the blood insertion. He said it is like a bruise, and should heal over time. It just seems I can't catch a break. I have been taking a holistic anti microbial supplement called SAMENTO by Nutra-Medix-or sometimes called Cat's Claw(are you familiar with it)for about 5 months-unfortunately I didn't realize that it is potentially a blood thinner(perhaps you can Google the product), and thus I guess I shouldn't have been taking it before the procedures that I have had(One LP and 2 blood patches). I spoke to the doctors about it, and they didn't seem overly concerned about it, but obviously nothing has really worked for me yet. I had the original LP on September 11th, and I feel as bad now as I did before the procedure. I still don't have a fever, but I am really not doing great. I am still having Lyme issues, and I know that has been adding to my anguish. Last night I woke in pain, and also, I felt very anxious and my body felt very over stimulated. I have a prescription for Lyrica, but have not started it yet. Please advise with any suggestion.
doctor
Answered by Dr. Luchuo Engelbert Bain (18 hours later)
Brief Answer:
Patience, recommend lying flat on back

Detailed Answer:
Hi and thanks for the detailed follow up question

I understand how disturbed you could be at this point in time. You need to be more positive for you really do not present with signs that could imply a new infection, nor aggravation of your neuroĺogical state.

I fully agree with your neurologist with regard to be patient when it comes to recovering from the post lumbar tap headaches. The suggested lying position will not only help in relieving the headaches but also the back pain.

With regards to the Lyme, I would love to know if you had any laboratory confirmation. You might need to go on a course of Doxycycline , an antibiotic for a couple of weeks if you never did before.

I would strongly recommend patience, lying position and simple analgesics . I am not very versed with the natural products you are taking, nor their efficacy . But I know also some of them are helpful.

Thanks and kind regards as I wish you the best if health.

Dr Bain
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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How Long Do Post-lumbar Puncture Headaches Last?

Brief Answer: Blood patch is satisfactory in most patients. Cautious waiting and 2nd opin Detailed Answer: Hi and thanks for the query, It is true that most lumbar tap headaches should fade out before the 9th week. However, it is not rare to see these headaches persist in some persons for over 16 weeks. The most important however is the evolution of the headache intensity. It is reassuring in case the intensity of the headaches do decrease as time goes on (even if they do persist). A headache of stable intensity of headaches that even get worse with time would require the opinion of your doctor to check for other possible complications (infection, brain oedema) that could be associated with the procedure. It is rare for a blood patch to make one feel worse, especially if the procedure is well indicated and performed appropriately. Over 90% of patients who undergo this procedure generally feel better. I would suggest patience, but being watchful. You might have to see your doctor again in case the symptoms do persist or aggravate. In case the feeling is stable or getting worse, a complete clinical review and a second opinion should be sought. Kind regards as I wish you the best of health. Dr Bain