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What Causes Headache Post Lumbar Puncture?
Question: I went to the ER due to severe headache approximately 30 hours after the mylogram on Friday morning. Because I have already been fused L4-S1, he did the myelogram above the fused area at approximately L3. During the myelogram, he warned me that the headache was likely. Fast forward to the ER Saturday night at 9pm...They decided to do a blood patch and as he injected the blood I felt a sharp pop to the right of the injection site and a lot of increased pressure in my head to the point that I had to ask him to quit. He ended up injecting 40cc of blood. As I was trying to lay down right after the procedure I immediately felt extremely severe pain at the site to the right and even slightly above and below the injection site. It was severe enough and went on long enough that I was sedated for about 30 minutes so things would calm down. They said it was muscle spasms but I've had back issues for twenty years and I've never had muscle spasms that hurt like these did. It was a terrifying experience and I'm trying to figure out what happened but I can't get answers. They sent me home today, I still have the headache but I'm terrified to do another blood patch. If I can figure out what happened, maybe I'd let them try a blood patch again because this is awful. It took me an hour just to type this out...
Brief Answer:
Imaging studies necessary to confirm the diagnosis.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
Headaches after lumbar puncture (done for different reasons) are mainly related to decreased intracranial pressure due to cerebrospinal fluid leak outside the spine coverings.
In these cases, headaches are worsened by upright position and improved by laying down.
If intracranial hypotension is confirmed, epidural blood patch is the best treatment.
Most cases improve significantly after one procedure, so, if you didn't improved sufficiently, intracranial hypotension should be reconsidered.
I think a lumbar spine and brain MRI are necessary to achieve a correct diagnosis, besides clinical findings.
Again, if your headaches are worsened by upright position and improved by laying down, intracranial hypotension is the most likely diagnosis, however confirmation with MRI is necessary.
If no such clinical findings, ( positional headaches ) your symptoms may be related to side effects of the contrast medium used.
It is true that pain at the punction site may be related to muscles spasms.
Adding a NSAID drug to your current medications ( ketoprofene for example ) may improve your symptoms.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Imaging studies necessary to confirm the diagnosis.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
Headaches after lumbar puncture (done for different reasons) are mainly related to decreased intracranial pressure due to cerebrospinal fluid leak outside the spine coverings.
In these cases, headaches are worsened by upright position and improved by laying down.
If intracranial hypotension is confirmed, epidural blood patch is the best treatment.
Most cases improve significantly after one procedure, so, if you didn't improved sufficiently, intracranial hypotension should be reconsidered.
I think a lumbar spine and brain MRI are necessary to achieve a correct diagnosis, besides clinical findings.
Again, if your headaches are worsened by upright position and improved by laying down, intracranial hypotension is the most likely diagnosis, however confirmation with MRI is necessary.
If no such clinical findings, ( positional headaches ) your symptoms may be related to side effects of the contrast medium used.
It is true that pain at the punction site may be related to muscles spasms.
Adding a NSAID drug to your current medications ( ketoprofene for example ) may improve your symptoms.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Above answer was peer-reviewed by :
Dr. Yogesh D
They said they won't do anything else for the spinal headache, so I'm a bit trapped. It won't last forever so I'll wait it out.
I hope you don't mind if I ask your opinion. After trying physical therapy three times, SI joint injections and SI joint nerve ablation that did help but didn't last, what kind of SI joint fusion would you recommend? I've seen so many kinds of hardware, I don't know what to do. If I were a member of your family (someone you like:), what kind would you recommend? Also, what kind of surgeon is right, neurologist or orthopedic?
Thanks so much for you help and time!!!
I hope you don't mind if I ask your opinion. After trying physical therapy three times, SI joint injections and SI joint nerve ablation that did help but didn't last, what kind of SI joint fusion would you recommend? I've seen so many kinds of hardware, I don't know what to do. If I were a member of your family (someone you like:), what kind would you recommend? Also, what kind of surgeon is right, neurologist or orthopedic?
Thanks so much for you help and time!!!
Brief Answer:
Minimally invasive fusion is the best way.
Detailed Answer:
Welcome back.
About your sacroiliac joint problems and pain, if the diagnosis is right ( in other words injections improved pain more than 75% ), and since conservative measures failed to improve your condition, surgery is considered.
In my opinion, fusion of sacroiliac joint with iFuse system, ( a minimaly invasive surgical procedure ) is one of the best options to improve your condition.
It is a surgical procedure performed by spine surgeons, (Neurosurgeons, or Orthopedic surgeons).
Hope I helped you.
Take care.
Minimally invasive fusion is the best way.
Detailed Answer:
Welcome back.
About your sacroiliac joint problems and pain, if the diagnosis is right ( in other words injections improved pain more than 75% ), and since conservative measures failed to improve your condition, surgery is considered.
In my opinion, fusion of sacroiliac joint with iFuse system, ( a minimaly invasive surgical procedure ) is one of the best options to improve your condition.
It is a surgical procedure performed by spine surgeons, (Neurosurgeons, or Orthopedic surgeons).
Hope I helped you.
Take care.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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