Headache after lumbar puncture to rule out meningitis

[lesa99]

My daughter has Spina Bifida, very mild case, that was diagnosed when she was 18. Several weeks ago she became ill with a temperature as high as 105.  Initially we thought she had influenza, alternating motrin and tylenol, and pushing oral fluids. Her temperature continued to wax and wane for a week, severe headaches and hallucinations. Her WBC was greater than 20,000, albumin level 1.5, lumbar puncture performed to rule out meningitis. Thankfully, meningitis was ruled out. However, she stayed in the hospital for a week, received antibiotics and pain management.  She was released with a WBC of 8.9, albumin level of 1.8 with no other electrolyte imbalance, persistent headache that improves only when she bends forward head toward the floor. Is a blood patch something that she should consider or will this improve in time?  Is having Spina Bifida Occulta a concern with regard to lumbar puncture and untoward complications?

[lesa99]

Hello,

  My daughter had the LP performed on 11/30.  The headaches are more severe in the afternoon. She has periods throughout the day without a headache. I am concerned because they are so severe. She is very stoic and does not complain unless it is very bad. Hopefully, considering a blood patch is premature, and since she does have periods of relief the symptoms will eventually subside.

Your advice is greatly appreciated.

Kindest regards.

[Dr_Veena]

Hi,
     How are you? A lumbar puncture (an LP) is the insertion of a needle into the fluid within the spinal canal. When spinal fluid is removed during an LP, the risks include headache, brain herniation, bleeding, and infection. Each of these complications are uncommon with the exception of headache, which can appear from hours to up to a day after LP. Headaches occur less frequently when the patient remains lying flat 1-3 hours after the procedure. Headaches are not related to spina bifida.

An epidural blood patch is an effective treatment for headaches occurring after a lumbar puncture. The common clinical impression is that total relief from the headache is immediate. There are some studies suggesting that pain relief may increase over the next several days. Complications include slight back pain, stiffness in the neck and low grade fever, which should resolve within about a day after the procedure. Recovery from a blood patch is therefore quite quick.

When has your child undergone LP? If it is persistent then you can consider a blood patch for her.
Best.