Lumbar Puncture, Blood Patches, etc.

November 13, 2006 at 9:02 am

A few details on an LP. The doctor puts a needle into your spinal column to draw spinal fluid for tests. A good doctor can often do so easily, with little pain, and with little damage to the sheathing of your spinal cord.

If you have an inexperienced doctor or have troubles, the needle penetration can build a hole in the sheathing through which your spinal fluid “leaks” … thus when you stand up, the spinal fluid creates a low pressure vacuum at the top (your head), and you have a horrible headache. That is why lying down (horizontal) is highly recommended for those with “spinal headaches.”

Even with a “spinal headache”, as long as you lie horizontal, you will be in minimal pain. If, however, you go vertical, the vacuum is created, and it can be horrific pain to the point of blacking out.

One membed commented on a cure for the spinal headache, the official term of which is a “blood patch”. This is very similar to a reverse LP. First, the doctor puts a needle (just like in the LP), into your spinal column. Then, using a second needle, blood is taken from an arm. The blood from your arm is immediately injected into your spinal area, slightly higher (~2 vertebrae) than where the original LP was performed. The blood is helped by gravity, and flows downward, hopefully flowing over the initial hole in the spinal column. The blood quickly clots, hopefully covering the hole and eliminating the spinal fluid “leak.” Within 10-15 minutes of the blood patch, the spinal headache is almost completely gone.

For shorter term relief, drink LOTS of fluids, and also take LOTS of caffeine. I am unsure as to the method of relief from caffeine, but a large amount in your system can temporarily relieve the pain of the spinal vacuum headache.

My most recent LP featured two residents, both of which were not very strong in their needlework. After 60 minutes with a needle in my back (and 3 separate holes into my spinal column), they finally got the fluid. However, I ended up with a very tough spinal headache with multiple leaks. Luckily, my wife is a physician, and after ripping the two residents apart for not getting assistance after they had trouble, my wife took me from the hospital I was in, to the hospital where she worked. She had an anathesiologist meet us in the ER, and I had the blood patch (completely done) within 5 minutes … it is amazing the difference of a skilled physician with the needle vs. the residents.

My word of advice: Make sure you have an experienced Doctor do the LP … with a good doctor, it is a very easy procedure. Don’t be afraid to tell any resident that you would like the attending to do the procedure.

Best regards,