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Spinal Tap (aka Lumbar Puncture) to Diagnose Headache Disorders

A common headache diagnostic tool, the thought of a lumbar puncture (often called a spinal tap) may terrify you. The length of the needle used is surprising, but the procedure is not that bad. At least, it wasn’t for me and I was needle-shy at the time. Many people have shared similar experiences with me.

Why Lumbar Punctures Are Used
Lumbar punctures are used to check for an underlying condition, like meningitis, hydrocephalus or subarachnoid hemorrhage. They can’t diagnose migraine or tension-type headache, but are used to rule out other possibilities.

What the Procedure is Like
Before the needle is put in, you are given local anesthetic. The anesthetic will sting or burn initially, but you’ll be grateful for it during the next step. After the anesthetic takes effect, the needle to draw the fluid will be inserted. You’ll feel a hard pressure in your back when the needle goes in and might have a few seconds of pain as it goes through the tissue. You may feel pressure while the fluid is being drawn.

The entire procedure takes about 30 minutes, but the part where the needle is in your back only takes a few minutes.

The Dreaded Lumbar Puncture Headache
I’d be lying if I said that spinal headaches following a lumbar puncture are uncommon. However, they are usually gone within 48 hours after the procedure. They are easily treated with pain relievers, lying flat, and drinking a little caffeine and lots of water and are usually gone within 48 hours.

If the headache lasts longer than 48 hours, most doctors will recommend a blood patch. For this, blood is drawn from your arm and then injected in the lumbar region. The blood then forms a clot to seal the puncture hole.

Nearly everyone has relief after a blood patch. Because I’m so special, I became a baseball fan during the three weeks following my lumbar puncture. The odds that you’ll have the same trouble are so low that I’ll spare you the details.

Tips For Your Lumbar Puncture

  • Schedule the procedure for a Friday so you can rest over the weekend.
    If you can send the kids to stay with Grandma and Grandpa, great!
  • If you can stomach it, ask the doctor to explain each step as you go along. Knowing what to expect relieves some of the fear.
  • Have someone drive you to your appointment so you don’t have to drive home. Even if you’re not in pain, you may feel woozy or “off” from nervousness.

Learn More About Lumbar Punctures

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An Extra-Special Birthday

My mom turns 61 today. She won’t be happy that I told you all how old she is (she insists she’s 27), but I am because I’m thrilled that she made it to 61. Days before her 60th birthday, she had brain aneurysm rupture. In med speak, it was a subarachnoid hemmorage.

While getting ready for work on that Thursday, she was hit with a sudden terrible headache, unlike any headache she’d had before. She felt sure that it was an aneurysm, but after she and my dad talked about all the people they knew who’d had awful colds in the few weeks before that, she didn’t go to the hospital, thinking she must have a cold.

After working the rest of the week and most of the weekend, she flew to Kansas to visit family. She had been feeling better, but after the flight, her head was raging and she was nauseated, weak, exhausted and disoriented.

Tuesday she went to the ER and had several tests, including a CT scan. Nothing turned up, and the doctor said it was probably a migraine. Nevermind that 60 is a strange age for migraine onset and it was nothing like her previous headaches. When she told me the diagnosis, none of this crossed my mind. I just said, “Oh, OK, what are you taking?” Then I told her that Advil would help more than Tylenol and left it at that.

She was in and out of ERs across Kansas for the rest of the week. She was given fluid and painkillers and doctors did more tests, none of which showed a problem.

Saturday morning she sent my dad to get coffee. He came back to find her passed out on the floor. An ambulance whisked her off to the hospital, where more tests showed that she had an aneurysm rupture that morning. It was actually a re-rupture; the first happened the previous Thursday. Turns out that CT scans show blood in the brain resulting from a rupture and the blood is visible for a short time afterward.

She was airlifted to the Nebraska Medical Center in Omaha, where she stayed almost three weeks and underwent three surgeries.

A year later, I’m happy to say that she is alive and well, with no lingering problems.

Several of the ICU nurses called her survival a miracle. I have to agree. Happy birthday, Mom!

I’m still one to say that more than 90%  of headaches are not caused by catastropic problems, like an aneurysm or brain tumor. But that doesn’t keep headache sufferers (including me) from worrying that they’re in the minority.

To learn more about brain aneurysms, see the Brain Aneurysm Foundation’s information section. Specifically, reading about the symptoms will help ease your mind.

This isn’t just my mom’s one-year anniversary, it’s also Brain Aneurysm Awareness Week 2005. I have yet to see publicity on this beyond the Brain Aneurysm Foundation, but I’ll share it with you if I do.