Epidural infiltration is a technique used to treat certain types of ailments that originate in the lumbar spine. It is a fairly safe procedure but it is not for everyone and complications can occur, although very rarely serious. Today I will talk about the headache after an epidural infiltration because it is the complication that has raised more questions on the blog. It is a quite common complication in this type of techniques.
Headache following epidural infiltration, in most cases, arises from unintentional puncture of the dural sac. The leakage of liquid through this barrier that we have broken causes more tension on the structures of the brain and dilate the blood vessels. We are going to understand it very easily with what I am going to tell you.
The dural sac is the protective barrier surrounding the brain and spinal cord. It is filled with fluid (cerebrospinal fluid) that protects these structures. The brain and spinal cord in this way are floating in a liquid. If we puncture this dural sac and there is a leak of cerebrospinal fluid occurs as if we removed the plug of the bath. All structures are pushed into the hole. In the case of the brain, this tension, indirectly pulling down, produces symptoms of headache after epidural infiltration.
What is the headache after an epidural infiltration?
Not all headaches are the same because the origin can be very diverse. The headache after an epidural infiltration is typical that it changes with the postures. The pain worsens when sitting or standing and is relieved when we lie on our backs. If it is not, it is possible that the headache is not due to puncture and our doctor should evaluate it, especially if the pain is severe or progressively worse.
The pain usually appears in the front or back of the head, ie in the area of the forehead or above the nape. It may take a few hours to appear, even up to 2-3 days. In addition to the pain, we may have nausea and vomiting, dizziness and other sensations such as visual disturbances and noises in the ear (tinnitus).
What should we do if we have a headache after an epidural infiltration?
Our doctor must be informed of the symptoms to have proper control. Not always the headache will be for this reason and you have to have a control of the possible complications. If it is a puncture of the dural sac as we have said, most of the time it will be solved in only one or two weeks. Because of this, a conservative treatment is recommended at the beginning where it is advised to remain lying in bed and given medication for pain. It is not worth any analgesic medicine because it is necessary to avoid those that alter platelets, such as aspirin, for example.
In mild pain you can expect to pass alone. If the pain is moderate or severe and has not improved after a day in bed, it is advised to apply a technique called an epidural blood patch.
This technique involves injecting blood from the patient into the epidural space so that a clot forms in the area of the ruptured dural sac. In this way we seal the leak of liquid. Applying the blood patch makes the degree of headache worse and removed earlier. Sometimes the puncture should be repeated if the first one has not been effective.