The release form is rather vague. The doctor is often vague. “About 20% of the people get the headache.” Ok, so, for a healthy, physically active female, this should be nothing. No risk. Um, yeah.
At a time ranging between 12 and 48 hours after the dural puncture (the dura is the membrane that covers the brain and spinal cord), a certain group of people experience a pressure drop in the cranial cavity due to leaking cerebral-spinal fluid (CSF). This pressure drop can be very small or very large, but in all cases, it is very painful. Not that the brain feels pain (it doesn’t), but the tissues surrounding it, and even the skull itself do. Nerved and blood vessels get crunched under the weight of the brain, which is no longer floating in a nice CSF bath. In fact, if care is not taken, you can get a nice concussion going. Yuck.
For me, the onset of the PDPH was about 22 hours after the puncture. I was driving to work when I noticed that my neck was becoming increasingly stiff and painful. That was my brain, snugging up to the rear cranial shelf, crimping some veins while it was at it. A quick check of the internet when I got to work revealed that yup, I had a PDPH. Ok…..
When I signed the form, my doctor was careful to tell me that there was no real cure for a PDPH except time. Pain pills don’t work. The only thing that works is lying down, to equalize pressure throughout the spinal and cranial cavities. You can take a bit of the edge off with caffiene and its wonderful vasoconstricting properties, but you cannot stand or sit up.
I spent the day with my laptop on the floor and my head between my knees. I kept this up for another two days, managing by keeping my head down, taking a small amount of acetaminophen, and a large amount of tea. Most interestingly, I could drink coffee. Normally, coffee makes me sick. Too much caffiene is too much stimulation for my poor little self. But in the throes of this mess, it was nothing. Not a single cell was jittered.