Know Your Pain

Spinal Headache and its Treatment

Spinal headache is the type of headache that worsens on standing and lessens on lying down. It results from loss of pressure in the skull due to a leak of cerebrospinal fluid.

What exactly is spinal headache?

The medical term for this condition is Spontaneous Intracranial Hypotension (SIH). Cerebrospinal fluid is a colorless fluid that flows in and around the brain and the spinal cord. This fluid is responsible for absorbing shocks and maintaining uniform pressure in the nervous system.

Cerebrospinal fluid flows through a membrane called dura which surrounds the brain and spinal cord. SIH occurs when there is a puncture in the dura. The cerebrospinal fluid seeps out through the puncture and the loss in pressure results in headaches that depends on posture. The severity is high when standing and almost vanishes when lying down. Apart from headache there could also be some other symptoms like hearing loss, vertigo, neck stiffness, nausea and increased sensitivity to light.

The cause of puncture could be trauma to the head or spine, brain surgery, spine surgery, or simply a weak dura. It could happen without any accident, trauma or surgery. There is no valid explanation as to why this happens.

What is the treatment for spinal headache?
In many cases, spinal headache vanishes as quickly as it emerges. If it does not, the only option available to doctors is to somehow plug the leaking aperture. The methods could be using glue to fix it or using a procedure called epidural blood patch.

For the epidural blood patch, a specific amount of blood is removed from the patient's body and injected into his lumbar spine. The blood flows through it and when it comes to the location of the puncture it clots. The puncture is sealed successfully this way in many patients. If it does not happen, the doctor has to find the exact location of the puncture and then inject the blood closer to the spot. This is certainly more effective and most of the times it does the job.

But in some patients the epidural blood patch does not work at all. The only alternative left for doctors then is to literally glue up the rupture. Fibrin glue is injected close to the rupture and guided by X-ray. Surgery may be required in some persistent cases to reach closer to the area and work on it. Surgery almost always seals up the affected area and prevents reoccurrence of leaks.