What Causes a Lumbar Puncture Headache?

A lumbar puncture headache is a complication associated with a cerebrospinal fluid (CSF) collection test, commonly known as a spinal tap. Headache develops when cerebrospinal fluid continues to seep into the spinal column following the test. In most cases, lumbar headaches subside independently within a couple of days as the puncture site heals. When treatment is necessary, approach is dependent on the severity of the headache.

According to the Mayo Clinic, an average of 30 percent of people who undergo a spinal tap will develop a lumbar puncture headache. A CSF test requires the extraction of a sample of cerebrospinal fluid for analysis. In some cases, the hole through which the sample is collected does not heal promptly, allowing for some spinal fluid to continue seeping into the spinal column. A headache develops when the loss of fluid diminishes pressure within the spinal column.

A cerebrospinal fluid test requires a small puncture to be made in the lower spinal column. After the area has been sterilized, it is treated with a local anesthetic. A small, hollow needle is introduced to the targeted area to collect the CSF sample. Once the sample is obtained, the needle is removed. Usually, the site is then sanitized again, dressed, and left to heal. Those who develop a lumbar puncture headache exhibit symptoms within 48 hours of the test.

Signs and symptoms of a lumbar puncture headache can vary depending on the severity of one’s condition. A minimal loss of pressure within the spinal column may cause a dull ache that may or may not be accompanied by lightheadedness. It is not uncommon for individuals to be nauseous and experience impaired vision with a lumbar puncture headache. Fever, stiffness, and outward seepage of spinal fluid are considered signs of serious complication that require immediate medical attention.

If one’s headache does not subside on its own within a couple days, treatment may be necessary. A physician may conduct imaging tests to verify one’s headache is caused by leaking spinal fluid and not something else. Once it is confirmed the headache is related to the CSF test, treatment options may be explored depending on the severity of one’s symptoms.

Analgesic, or pain reliever, medication is usually the first step in any treatment approach. If analgesics prove insufficient, the individual may be given an intravenous treatment to stop CSF fluid from continuing to seep into the spinal column. Either saline solution or the individual's own blood may be introduced into the puncture site in an effort to increase pressure.