Anesthesiol Res Pract. 2010;2010. doi: 10.1155/2010/102967. Epub 2010 Aug 11.

Postdural puncture headache.

Anesthesiology research and practice

Ahmed Ghaleb

PMID: 20814596 PMCID: PMC2931374 DOI: 10.1155/2010/102967

Abstract

Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is 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 , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24-48 h of dural puncture. The optimum volume of blood has been shown to be 12-20 mL for adult patients. Complications of AEBP are rare.

References

1. Anesthesiology. 1978 Aug;49(2):147-8 - PubMed
2. Acta Anaesthesiol Scand. 1995 Jul;39(5):613-7 - PubMed
3. Br J Anaesth. 1985 May;57(5):538-40 - PubMed
4. Anesthesiology. 1990 Dec;73(6):1287-9 - PubMed
5. Anesth Analg. 1989 Oct;69(4):522-3 - PubMed
6. Br J Anaesth. 1994 Mar;72(3):366-7 - PubMed
7. Br J Anaesth. 1988 Sep;61(3):340-2 - PubMed
8. Anesth Analg. 1985 May;64(5):501-4 - PubMed
9. Anesthesiology. 1995 Jun;82(6):1474-506 - PubMed
10. Anaesthesia. 1980 May;35(5):513-5 - PubMed
11. Reg Anesth. 1989 May-Jun;14(3):101-6 - PubMed
12. J Am Med Assoc. 1956 Jun 16;161(7):586-91 - PubMed
13. BMJ. 1993 Apr 3;306(6882):874-6 - PubMed
14. J Clin Anesth. 1993 Jan-Feb;5(1):42-5 - PubMed
15. Br J Anaesth. 1990 Nov;65(5):721-2 - PubMed
16. Br J Anaesth. 1992 Oct;69(4):401-3 - PubMed
17. Anesthesiol Clin North Am. 2000 Jun;18(2):461-85 - PubMed
18. Anesth Analg. 1994 Jul;79(1):180-2 - PubMed
19. Anesthesiology. 1999 Dec;91(6):1937-41 - PubMed
20. Anaesthesia. 1993 Mar;48(3):247-55 - PubMed
21. Br J Anaesth. 2003 Nov;91(5):718-29 - PubMed
22. Anesthesiology. 1986 Jun;64(6):820-2 - PubMed
23. Br J Anaesth. 1993 Aug;71(2):182-8 - PubMed
24. Acta Anaesthesiol Scand. 1995 Jul;39(5):605-12 - PubMed
25. Reg Anesth. 1997 Mar-Apr;22(2):161-6 - PubMed
26. Anesth Analg. 1996 Apr;82(4):766-9 - PubMed
27. Anesth Analg. 1972 Mar-Apr;51(2):226-32 - PubMed
28. Anesth Analg. 1990 Feb;70(2):181-4 - PubMed
29. Reg Anesth Pain Med. 2001 Mar-Apr;26(2):178-80 - PubMed
30. CMAJ. 2001 Nov 13;165(10):1311-6 - PubMed
31. Reg Anesth. 1989 Mar-Apr;14(2):78-80 - PubMed
32. J Neurosurg. 1959 Jul;16(4):424-47 - PubMed
33. Anesthesiology. 2001 Aug;95(2):334-9 - PubMed
34. Reg Anesth Pain Med. 2004 Mar-Apr;29(2):136-63; discussion 135 - PubMed
35. Anesthesiology. 1974 Sep;41(3):307-8 - PubMed
36. Reg Anesth Pain Med. 2001 Nov-Dec;26(6):582-7 - PubMed
37. Acta Anaesthesiol Scand. 1993 Oct;37(7):702-5 - PubMed
38. Br J Anaesth. 1988 Feb;60(2):195-7 - PubMed
39. Anaesthesia. 1975 Nov;30(6):783-5 - PubMed
40. Anesthesiology. 1989 May;70(5):729-31 - PubMed
41. Anaesthesia. 1997 Aug;52(8):808 - PubMed
42. Anaesthesiol Reanim. 1991;16(6):375-8 - PubMed
43. Can Anaesth Soc J. 1979 Mar;26(2):132-3 - PubMed
44. Acta Anaesthesiol Scand. 2003 Aug;47(7):878-83 - PubMed
45. Anesth Analg. 1970 Mar-Apr;49(2):268-71 - PubMed
46. Reg Anesth. 1997 Jan-Feb;22(1):66-72 - PubMed
47. Anesthesiology. 1999 Aug;91(2):576-7 - PubMed
48. Can J Anaesth. 1999 Sep;46(9):878-86 - PubMed
49. Anesth Analg. 1989 Oct;69(4):457-60 - PubMed
50. Anesth Analg. 1975 Jul-Aug;54(4):459-63 - PubMed
51. Reg Anesth Pain Med. 2000 Jul-Aug;25(4):393-402 - PubMed
52. Anaesthesia. 1991 Sep;46(9):794 - PubMed
53. Anesthesiology. 2000 Jan;92(1):272-4 - PubMed
54. Anesth Analg. 1997 Mar;84(3):585-90 - PubMed
55. Neurol Clin. 1998 Feb;16(1):83-105 - PubMed

Publication Types

• Journal Article