Expert: Dr Ian Jackson - please note UK based - 2/23/2009

Question
My son had a spinal on the 30th of Jan. He has had headaches everyday after the first 24 hours, I have called right away to this dr.'s and get different people each time. They had me go to the GP for sinus infection, with not the slightest cold symptom. They don't believe it has to do with the spinal tap because 1. it didn't start right away-after 24 hours. and 2. because it has lasted so long-21 days now. If he stands up, bends over, and pushes (naturally) to urinate he feels the pressure and instant headache. He has been drinking caffeine, best rest a few times. But once he gets up, it comes back. He has had a CAT scan, and blood count and they were fine.
Any suggestions? Thank You for your time

Answer
Hi there
You don't mention how old your son is or what he had the spinal for but my advice would probably be the same.
If the headache settles when lying down and gets worse as you say when he gets up etc then it does sound like a classical 'Post dural pucture spinal headache' I wil assume from your question that you have already looked this up on the internet.
Typically these are self limiting and go after 7-10 days. However I am aware of people who have had problems for a lot longer.
I feel you need to find a receptive anaesthetist who believes that this is the problem and persuade them to do what is called a 'blood patch'. This entails your son having an epidural needle inserted into his back, someone taking 20mls of blood from his arm and then this being injected slowly into the epidural space in his back. The idea is for this to form a seal over the hole in his dura and so allow it to seal.
I have seen people helped months after the spinal with this technique.
I can't offer much other help I'm afraid as I'm sure you are doing all the right things.
Kind regards
Dr Ian Jackson