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May 13, 1974

Postspinal Headache

Author Affiliations

Permanente Medical Group San Francisco

JAMA. 1974;228(7):827. doi:10.1001/jama.1974.03230320015011

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To the Editor.—  The Brief Report by Cass and Edelist (227:786, 1974) reminded me of a successful treatment that I came across when suffering from the malady myself several years ago. In their article no reference was made to the remedy I will describe, nor have I been able to find it in the standard neurologic texts.Recall that when a spinal tap is performed, the patient assumes a "fetal position," and with the needle in place a high intraspinal pressure is recorded on the manometer. As the patient straightens his body, the intraspinal pressure drops, and it is generally at this time that the manometer pressure reading is taken, which is, of course, lower. One of the characteristic features of postspinal headache is that it is worse on arising in the morning and may improve as the day goes on. This generally has been attributed to dehydration occurring overnight