Expert: Dr Ian Jackson - please note UK based - 8/30/2009

Question
QUESTION: I had a spinal anaesthetic on the 7th August 2009 for a minor surgery.Have had a dull headache and constant dizziness ever since. Went to my G.P. He just said it will go away eventually.Cant go out as I just don't feel good at all.

ANSWER: Hi Ann
I am sorry to hear that you are having this problem. It sounds like you have what is termed a post dural puncture spinal headache. If it gets better when you are lie down and seems worse when you get up then that is fairly certain what it is. Basically to do the spinal anaesthetic the anaesthetist puts a small needle into the fluid filled sac in your lower back. In around 1 in 100 to 1 in 200 people this will result in a headache like I have described. This apears to be due to a continued slow leakage of the fluid in the sac through the hole which for some reason doesn't close up as it normally does. Indeed we use very special needles that are supposed to help the hole close over afterwards - but even so it does happen.
Your GP is right that this is usually a self limiting and settles down over a 2-3 week period, however in a very few individuals it can continue as a problem for longer. I suggest if this continues to cause you problems then you should contact the Anaesthetic Department of the hospital where you had the procedure. Contact them during normal working hours so there is a chance that they might be able to get someone to chat to you about this problem.
There are things we can do to treat it but this normally involves another injection in your back and really the use of this depends on your age, fitness and willingness to undergo the procedure once it has been exlained! I'm sorry but that's all I can offer really except finally in the unlikely event of you not getting anywhere with the Anaesthetic Department then print this off and get your GP to get you seen by them.
I am aware of this as in issue for the patients of my department and have set up systems to try and let them get in contact with us if they do have problems.
Kind regards
Dr Jackson

---------- FOLLOW-UP ----------

QUESTION: My Anaesthetist has told me to go home and consider having a blood patch.says its my choice I don't know what to do have a spinal puncture headache for 24 days now. Eases when lying down but thumping when stand up also pins and needles in face

Answer
Hi there Ann
It sounds like your anaesthetist is being very sensible and has given you the info but is leaving the choice to you. This is correct. Given the duration of the headache we are into slightly unfamiliar territory - as I mentioned it usually passes well within 3 weeks. However I am increasingly aware of a small number of patients across the world who have had more prolonged problems. I can't make your mind up for you and there is no guarantee that the blood patch will work. However if you are being debilitated every day with the headache then perhaps it is worth a try?
Kind regards
Dr Ian Jackson