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Anesthesia

Headache after epidural

07/17/2007

Question:

I recently had a spinal epidural during childbirth and am now having severe headaches. The difference is the headache began about a week ago and my child is 5 weeks old. I realize this is an extended period of time. Is there a possible relation?

Answer:

Most post-dural puncture headaches (PDPH) - the official name for a spinal headache - occur with a few hours to days after a recognized dural puncture. A dural puncture is when the needle penetrate the dura - the membrane containing the spinal fluid, nerves and spinal cord. Your headache is unlikely to be due to PDPH because its onset a month later is so far from when the epidural was performed. Another factor is that, unless you have forgotten to mention it, there was no obvious dural puncture - in most case when this occurs, the doctor is aware that the needle has made a hole in the dura.

There are many cause for severe headache, and quite a few of these can have very serious consequences. Unless these headaches conform to a previous pattern with a known, benign cause, like tension headache or migraine, you should definitely seek immediate medical attention.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University