Post Lumbar Puncture Headaches

The number of patients who suffer from post lumbar puncture headaches has decreased. At the beginning of the 20th century, the percentage was 60%. Today, it’s 11%, when the puncture is made with a fine needle.
Post Lumbar Puncture Headaches

Written by Edith Sánchez

Last update: 27 May, 2022

Experts estimate that post lumbar puncture headaches affect approximately 40% of patients who undergo a spinal tap or spinal anesthesia. In general, it’s a condition that resolves on its own.

Lumbar puncture is a procedure that’s performed to apply local anesthesia or for diagnostic or therapeutic purposes. Sometimes, it causes a reduction in intracranial pressure and this, in turn, leads to headaches.

Medical professionals performed the first lumbar punctures in the late 19th century. At the beginning of the 20th century, the incidence of headaches from this procedure was 60%. Over time, this percentage has been decreasing and continues to do so until today.

What’s a lumbar puncture?

Lumbar puncture.

Lumbar puncture is a clinical procedure whose purpose is to extract cerebrospinal fluid. Also, it’s performed to apply anesthesia or a drug. This fluid is found around the brain and spinal cord. It acts as a kind of cushion.

During the procedure, the doctor inserts a needle between two lumbar vertebrae and into the spinal canal. Depending on the goal of the lumbar puncture, one of the following actions is carried out:

  • The medical professional removes a small amount of cerebrospinal fluid, which another professional will examine in the laboratory.
  • A certain amount of fluid is removed to reduce the pressure in the spinal canal.
  • Then, the medical professional injects some anesthetic.

After that, they remove the needle. However, if there’s a very large loss of cerebrospinal fluid, the pressure of the cerebrospinal fluid reduces in the cranial cavity, and this causes a headache.

Headache and lumbar puncture

Post lumbar puncture headaches usually present as bilateral pains. In other words, on both sides of the head. It’s common for them to manifest immediately and, in any case, within a period that doesn’t exceed five days after the procedure. The normal thing is for them to disappear spontaneously in less than a week.

In typical cases, the pain worsens when the patient is sitting or standing. Therefore, medical professionals recommend that you remain lying down. The headache occurs mainly in females between the ages of 8 and 30 and who have a small body mass.

On the other hand, the manifestation of post lumbar puncture headaches largely depends on the type of needle the surgeon used, the technique applied, and the skill of the surgeon who performed the procedure. The smaller the needle gauge, the less risk of headaches. Very thin needles reduce the percentage of affected patients to 11%.

Symptoms and diagnosis

The main symptom of post lumbar puncture headaches is dull, throbbing pains that range in intensity from mild to downright disabling. The pain worsens when the patient stands up and decreases when they lie down.

The headache may be accompanied by other symptoms, such as dizziness, ringing in the ear, double or blurred vision, nausea, hearing loss, and neck stiffness and pain. Magnetic resonance images reveal a decrease in intracranial structures, among other signs.

The diagnosis is clinical. Sometimes, the doctor will order an MRI or other similar studies to rule out other possible causes of the headache.

This article may interest you: The Importance of Your Spinal Column

Other data to take into account

Medical professionals advise patients to lie down for a period of not less than 12 hours if a headache occurs after a lumbar puncture. The pain usually manifests 15 minutes after sitting up. Thus, the patient can still do things such as getting up to go to the bathroom or to eat.

Drinking plenty of fluids helps to recover the cerebrospinal fluid that was lost, especially during the 24 hours following the procedure. Likewise, unless a medical professional indicates otherwise, it’s advisable to drink coffee or drinks that contain caffeine.

The headache should subside. If it’s very intense or doesn’t subside at all for several hours after the procedure, the patient will need to consult their doctor. Also, if there’s vomiting and leg tingling or numbness. Likewise, if there are difficulties urinating or pain or bleeding occurs at the site where the surgeon inserted the needle.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Herrera Salas, S. (2016). Cefalea post punción lumbar. Revista Médica de Costa Rica y Centroamérica, 73(620), 443-448.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.