Post spinal headache true is
Not become better on recumbent
Better with caffeine
More pressure dependent than volume
Starts immediately
Ans. (b) Better with caffeine(Ref: Postgrad Med). 2006 Nov; 82 (973): 713-716.)Post spinal headache:* Post spinal headache is defined as "bilateral headaches that develop within 7 days after an lumbar puncture and disappears within 14 days* Headache after lumbar puncture occurs more often in young adults, especially in the 18-30-year age group.* Young women with a lower body mass index and those who are pregnant have the highest risk of developing headaches after lumbar puncture.* 1/3rd of the patient develop spinal headache.* Usually occurs after 24-48 hours of Spinal injection.* Spinal headache depends on the size of needle used, Number of attempts used to puncture, direction and design of the bevel in needle etc* The most important cause for headache is not the pressure in the CSF but the volume of fluid leaking.* The headache worsens within 15 min of resuming the upright position, disappears or improves within 30 min of resuming the recumbent positionManagement:* Conservatively more than 85% cases are cured.* Supporting treatment such as rehydration, simple analgesics, opioids and anti-emetics may control the symptoms in milder cases.* Epidural patch closure, Caffeine, Epidural Hypertonic Saline or Dextran injection are used.* Increased oral fluids is found recently as no benefit in the reduction of symptoms.
Nervous System