Prolonged headache in 13 year old after spinal tap

Question

My son had a fever lasting 3-4 days with severe headache. He had a lumbar puncture to rule out bacterial mennigitis. A day or so after this procedure his fever went away but the headaches have gotten worse. We have noticed a pattern that the headache is worse when he sits up. When he lays flat on his back the headache is controllable. We returned to the doctor 3 days after the lumbar puncture and he was given a massive dose of caffeine and pain pills. It will be a week in 2 days and we are wondering what to do next? We are reluctant to go back to doctor because the caffeine and pain pills were just a temparary fix. Thanks, Tamara

VanessaMD · Answer

Hi

Yes. I would suggest a follow up consult with the physician. If the symptoms still persist that is , if the pain is still present upon standing or moving around then further management and evaluation may be needed. This appears to be a spinal headache and as I have posted in my previous post, other options may be considered if indicated. Just keep him in bed until he is assessed by his physician once more.

tammy330 · Answer

Thanks for the quick response as I am at the end of my worry rope!  We have been doing the bed rest for almost a week.  Tomorrow will be 1 week since the tap.  Do you think I should take him back?  He is not excited about the having more lumbar procedures done but is frustrated remaining flat on his back the first week of summer vacation!

VanessaMD · Answer

Hi

This may be what is termed as a spinal headache. "During a spinal tap, a sample of cerebrospinal fluid is withdrawn from your spinal canal. During spinal anesthesia, medication is injected into your spinal canal to numb the nerves in the lower half of your body. If spinal fluid leaks through the tiny puncture site, you may develop a spinal headache. "

Source:http://www.mayoclinic.com/health/spinal-headaches/DS00643

I believe the physician has been thinking along this line. Your son may need to be in complete bed rest. Is he in complete bed rest right now? I suggest that you have this followed up by his physician as this is supposed to resolve in a day or two. There may be other options involved like an epidural saline and epidural blood patch.