Intraoperative headache means headache occurring during a procedure, usually when the patient is awake under local, spinal, epidural, or regional anesthesia. A person under full general anesthesia cannot report it until waking.

After spinal or epidural anesthesia A headache that starts within a few days and is markedly worse sitting or standing but relieved lying flat suggests post-dural puncture headache from CSF leakage. It needs anesthetic review and may require an epidural blood patch if severe or persistent.

Immediate action in theatre Tell the anesthetist/surgeon immediately. They should check blood pressure, oxygenation, ventilation, glucose, pain control, medications, fluid status, and neurologic signs.

Urgent red flags Sudden “worst-ever” headache, confusion, fainting, seizure, weakness/numbness, speech or vision changes, persistent vomiting, fever/neck stiffness, or very high BP require urgent assessment.

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