About one or two percent of patients who receive an epidural experience an epidural headache afterward. Before we start to discuss the symptoms and types of treatment available, I would first like to explain how an epidural is administered and why severe headaches can follow the procedure.
A spinal epidural is a procedure in which a regional anesthetic is administered to the patient’s spine. This form of anesthetic is most commonly administered to women during labor. The human body has an important fluid called Cerebrospinal Fluid. This fluid plays an important role in protecting the brain from bumping against the skull, as well as providing cushioning for blood vessels near the brain and spine. The actual space that surrounds the brain and the spine are called the Dura, which lies just beyond the thin epidural area (the target for epidural anesthesia needles). When an epidural needle goes a bit too far and punctures the Dura, a spinal fluid leak can occur. It is usually a very small hole, but if it is large enough for even the tiniest amount of spinal fluid to leak out, epidural headaches could possibly follow.
The headaches may occur because the loss of spinal fluid results in the brain having less cushioning against the skull, creating a sagging or spreading sensation of the brain. The body’s way of letting us know about this is through pain sensory (a headache). A headache can also be caused if the loss of spinal fluid causes the blood vessels in the brain to expand, or dilate.
When the spinal fluid leaks, more than just a severe headache can result. Double vision is a common symptom of a spinal headache, as is sensitivity to light. If you happen to experience these symptoms, don’t put yourself in a dangerous position such as driving—get someone to chauffeur you around or schedule an appointment with your doctor to inquire about the severity of your spinal fluid leak. Nausea, Neck pain, as well as a decrease in the sharpness of your hearing, may also crop up. If they become unbearable or last longer than a few days, you should contact your doctor to inquire about any treatments he may be able to offer you.
Most often, epidural headaches usually fade away naturally over two to four days; however, this is not always so in the event that a larger leak has occurred. Sometimes a large leak requires an epidural blood patch to be performed. Basically, a bit of blood is drawn from the patient’s arm and is injected into the epidural area. The blood will clot and seal off the hole in the Dura causing the spinal fluid leak and the headaches should subside soon after. Some patients report a moderate achy back for a few days following the blood patch, but nothing so severe that a mild pain reliever such as Tylenol or ibuprofen can’t relieve. If, after the epidural blood patch is performed, the headaches (and other symptoms, if they are present) do not go away, the second attempt at a blood patch may be performed.
If you believe you may be experiencing symptoms of a spinal fluid leak, it is best to call your doctor for advice or to schedule a checkup—especially if the headaches seem unbearable. Remember to report anything going on in your body that isn’t quite normal, as it may be vital in determining the severity of your condition. If your headache doesn’t seem too severe but is still strong enough to limit some of your functioning, ask your doctor if there are any at-home remedies you could perform to relieve or minimize the pain.
An epidural headache: The Symptoms You’ve Never Heard Before, Last Update: 14/6/2017