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Post-dural puncture headache
Authors Ghaleb A, Khorasani, Mangar
Received 27 August 2011
Accepted for publication 25 October 2011
Published 12 January 2012 Volume 2012:5 Pages 45—51
DOI https://doi.org/10.2147/IJGM.S17834
Review by Single anonymous peer review
Peer reviewer comments 4
Ahmed Ghaleb1, Arjang Khorasani2, Devanand Mangar3
1Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, 2Anesthesiology Residency Program, Advocate Illinois Masonic Medical Center, Chicago, IL, 3Florida Gulf to Bay Anesthesiology, Tampa General Hospital, Tampa, FL, USA
Abstract: Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH) has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24–48 hours of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP) are rare.
Keywords: post-dural puncture headache, gauge, needles, cause, risk, incidence
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