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Chapter 11 - Post-dural Puncture Headache

from Part III - Chronic Pain Conditions Head and Neck

Published online by Cambridge University Press:  01 December 2023

By
Nolan Weinstein  and
Jatinder Gill
Edited by
Omar Viswanath  and
Ivan Urits
Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Common adverse complication following dural puncture (DP) during epidural orspinal anesthesia which results in symptoms such as dull throbbing headache, fronto-occipital distribution, worse in seated position, alleviated when supine. Other symptoms include nausea, vomiting, neck stiffness, and tinnitus. Adverse event is seen commonly in patients receiving epidural or spinal neuraxial anesthesia, which occurs following inadvertent puncture of the dura. Conservative treatment is often adequate in majority of the patients, but medical management can be used liberally with a variety of safe, well-studied pharmacologic options. Epidural blood patch is the gold standard in treating unremitting PDPH but should be used cautiously due to the potential for rare but serious complications.

Keywords

post-dural punctureheadacheepiduralspinalepidural blood patch
Type
Chapter
Information
Cambridge Handbook of Pain Medicine , pp. 69 - 74
Publisher: Cambridge University Press
Print publication year: 2023

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References

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