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CNS Drugs
Published in: CNS Drugs 1/2000

01-01-2000 | Disease Management

Postdural Puncture Headache

Pathophysiology and Treatment Options

Authors: Dr William Camann, Steven Finkelstein

Published in: CNS Drugs | Issue 1/2000

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Abstract

Postdural puncture headache (PDPH) is an infrequent, but troubling, syndrome following therapeutic or diagnostic dural puncture. The classic feature of PDPH is its postural nature: worse when upright and relieved when supine. Other findings such as visual and auditory changes, nausea, vomiting, neck pain and cranial nerve palsies may occur. The syndrome typically occurs 1 to 3 days following dural puncture. The pathophysiology is related to leakage of CSF, with resultant cerebral traction and reflex vasodilation. PDPH is more common in young patients.
Prevention is most important, and can be achieved by using the smallest possible noncutting spinal needles. Bed rest is not necessary following dural puncture as a preventative measure.
Treatment options include bed rest, oral analgesics and epidural blood patch (EBP). Prompt use of EBP is usually warranted if no symptomatic relief is apparent within 48 to 72 hours. Prolonged symptoms, especially if the patient is unresponsive to EBP, should prompt consideration of other aetiologies of headache.
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Metadata
Title
Postdural Puncture Headache
Pathophysiology and Treatment Options
Authors
Dr William Camann
Steven Finkelstein
Publication date
01-01-2000
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 1/2000
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200013010-00002

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