A spinal headache, or postdural puncture headache, is a common side effect experienced after an attempted epidural injection. It occurs when the dura, or the tissue surrounding the spinal cord, is punctured and cerebral spinal fluid leaks into the epidural space. According to an article called "Postdural Puncture Headache" that appeared in 2010 in "Anesthesia Research and Practice," postdural puncture headaches occur in 16 to 86 percent of patients receiving an epidural injection with a large bore needle. Among oral rehydration and other medical treatment options, caffeine has been used to treat a spinal headache. Be sure to ask your doctor if it is OK for you to treat your spinal headache with caffeine.
Spinal Headache
Cerebrospinal fluid bathes the brain and spinal cord. Specifically, this fluid acts as a cushion for the central nervous system and is involved in many of its metabolic processes, as stated in "Neuropathology," an illustrated interactive course at the Northeastern Ohio Universities College of Medicine. Dural puncture typically causes a severe spinal headache that is worse with walking and better with sitting within 48 hours of the dural puncture. In addition to a spinal headache, you may experience nausea, vomiting and neck stiffness and vision changes.
Caffeine
Caffeine has been shown to be an effective treatment for a spinal headache. Specifically, a caffeine intravenous bolus or infusion was found to be effective in reducing a mild spinal headache in 75 to 80 percent of patients with a postdural puncture headache, according to the aforementioned Anesthesia Research article. It is theorized that methylxanthines, a component of caffeine, constricts blood vessels in the brain to reduce blood flow. The reduction in symptoms, however, is temporary and other treatments may be needed.
Cafergot
Caffeine may be combined with ergotamine to reduce the spinal headache associated with a postdural puncture. Ergotamine constricts blood vessels, similarly to the action of methylxanthines, and is also commonly used to treat migraine headaches. Cafergot is a combination of caffeine and ergotamine given to relieve a spinal headache. When taken for a spinal headache, cafergot has been shown to reduce symptoms in nearly 100 percent of patients, according to a small study presented in the September 1994 issue of the "Journal of the American Society of Anesthesiologists."
Recommendations
If you are experiencing a headache from a dural puncture, ask your doctor if caffeine, or cafergot, is an appropriate treatment. Avoid consuming caffeine without consulting your physician. Let your doctor know if caffeine is ineffective in treating your headache, because further study may be needed to determine other possible causes of a spinal headache. In some cases, more invasive treatments are needed to relieve symptoms.
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