[Prospective studies on the pathologic mechanism of post-spinal headache in a select group of patients (author's...

In this prospective study 613 patients on whom a total of 783 spinal anaesthetics had been performed, all for urological operations, were questioned and examined. Subjective complaints occured in 102 cases (13%) and were found to be more frequent amongst the female patients. 23 cases (2.9%) developed a typical post-spinal headache, this being more likely to occur if the patient was a woman, was young, and if a 22-Gauge needle was used. The headache usually began on getting up on the day of operation or the first post-operative day, and rarely lasted longer than four days. The pathophysiological changes indicate that the headache is caused by a fall in CSF pressure. The therapy and various methods of preventing this complication are discussed, and the other potential neurological symptoms and signs mentioned.