Article: If your headache does not resolve within 24 hours, despite taking steps mentioned above, get an epidural blood patch.  During an epidural blood patch procedure, a small amount of your own blood will be injected in the space just outside the perforation in your spine. The blood will clot, sealing the perforation and restoring pressure in the spinal membrane. This restores spinal pressure and stops further leakage, relieving headache symptoms. The success rate of this technique is more than 70%. Usually, 15-30 ml of your blood will be taken from your arm, and then you will lie on your side for 2 hours. This procedure can be repeated up to 2 times if the primary attempt fails to control headache. An epidural blood patch should not be done if you have a fever or skin infection. A saline solution such can be injected into the epidural space instead of blood.  It produces a similar effect as blood, but is sterile and comes with a much lower risk of infection. However, saline solution is thin and rapidly absorbed by the epidural space, meaning that the pressure is not as effectively maintained as with a blood epidural. 1–1.5 liters (0.4 US gal) of Hartmann saline solution can be administered over a 24 hour period, starting the same day of the spinal tap or anesthesia. Surgery is the last treatment option for spinal headache.  When all other measures fail to stop a spinal leak, surgery can be attempted to repair the perforation. It immediately stops the CSF leak, but carries the risk of infection and is somewhat invasive. Therefore, your doctor will counsel you thoroughly (regarding the procedure, and its pros and cons) before undergoing surgery. By using a small needle, the risk of spinal fluid leak is dramatically reduced, because the likelihood of a leak is related to the size of the needle perforation.  Using an appropriately needle size and shape can minimize the likelihood of spinal headache. A large needle bore will produce a large perforation, so it is always best to use small bore needles, usually between 24-27 gauge. Use a pencil point needle instead of a cutting type to minimize the chance of leakage. If possible, use a new type of needle, known as an Atraucan needle that has a narrow cutting tip and a bevel that greatly reduces the chance of spinal headache. Orientation of the needle is also important. If the beveled edge of the needle is kept horizontal when it is introduced, there a greater chance of tissue damage. The beveled edge should always be kept vertical and parallel to the fibers.

What is a summary?
Get an epidural blood patch for severe chronic headache. Try an epidural saline solution. Get surgery as a last resort. Make sure an appropriate needle is used during your spinal tap or anesthesia procedure. Make sure the needle is oriented properly.