Post spinal headache is due to
CSF leaks in the dura
Fine needle
Toxic effects of the drug
Traumatic damage to nerve roots
A. i.e. (CSF leaks in the dura) (517- Lee's synopsis of anaesthesia 13th)* It is low pressure headache due to seepage of CSF from dural rent (hole) created by spinal needle. The loss may be around 10 ml /hrPost spinal headache - is due to seepage of CSF. Can be minimized by using smaller bore needle (360-KDT 6th)* More common in young pregnant patients and with accidental dural puncture rate during epidural anaesthesia using Touhy needle (60 - 80%). Reduced by the introduction of size 25 G and 27G whitacre pencil point needles. Which replaced cutting needles* Typical location is bifrontal and /or occipital* CSF leakage results in changes in hydrodynamics of brain causing traction on pain sensitive structures like dura, vessels and tentorium producing painTreatment - Caffeine, sumatriptan and adreocorticotropic hormoe, "epidural blood patch"* Related to a reduction in CSF volume due to leakage through the dura (300 - Current. Diagnosis and treatment - pain)
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