Headache following lumbar puncture (LP) occurs in approximately one-third of patients. The pathophysiology of is unclear but may relate to a 'leak' of CSF following dural puncture. Post-LP headaches are more common in young females with a low body mass index

Typical features

• usually develops within 24-48 hours following LP but may occur up to one week later
• may last several days
• worsens with upright position
• improves with recumbent position

Management

• supportive initially (analgesia, rest)
• if pain continues for more than 72 hours then specific treatment is indicated, to prevent subdural haematoma
• treatment options include:
  • IV Caffeine and fluids
  • blood patch
  • epidural saline