With a lumbar puncture, commonly known as a spinal tap, a needle is stuck in the lower spine to take a sample of cerebrospinal fluid for diagnostic purposes or to deliver medication or anesthesia. It is not a pleasant procedure—particularly for patients who develop a postdural puncture headache (PDPH). The most common complication of lumbar puncture, PDPH typically arises within 15 minutes of sitting or standing up after the procedure… involves constant pain, particularly when a person is upright… can take a week or longer to go away… and sometimes requires additional invasive treatment involving injections into the spine.
A number of different medications commonly are used to treat PDPH, but their effectiveness has been uncertain. So, in a recent study, researchers reviewed data from seven clinical trials involving various PDPH treatments. What worked best: Caffeine given intravenously or orally often relieved PDPH within two hours and produced no significant adverse side effects. Also effective: Medications that decreased PDPH pain included oralgabapentin (an antiseizure drug), oral theophylline (an asthma drug) and intravenous hydrocortisone. Ineffective: Injections of sumatriptan (a migraine medication) or a hormone called ACTH did not relieve PDPH symptoms.
Recommended: If you need a lumbar puncture, talk to your doctor about caffeine treatment if you develop a headache afterward. Stay tuned: Researchers are working now to assess the effectiveness and safety of various drugs in preventing PDPH.