Etiology, management, and sequela of postdural puncture headache

• Published in: Current opinion in anaesthesiology Vol. 36; no. 5; p. 565
• Main Authors: Taraskiewicz, Daniel, Sheeran, Jessica, De Marco, Paul, Tiouririne, Mohamed, Elkassabany, Nabil
• Format: Journal Article
• Language: English
• Published: United States 01.10.2023
• Subjects: Anesthesia, Obstetrical - adverse effects; Blood Patch, Epidural - adverse effects; Humans; Incidence; Post-Dural Puncture Headache - epidemiology; Post-Dural Puncture Headache - etiology; Post-Dural Puncture Headache - therapy; Retrospective Studies; Risk Factors
• ISSN: 1473-6500
• DOI: 10.1097/ACO.0000000000001286

The purpose of this article is to provide readers with a concise overview of the cause, incidence, treatment of, and sequalae of postdural puncture headaches (PDPH). Over the past 2 years, much data has been published on modifiable risk factors for PDPH, treatments for PDPH, and sequalae of PDPH particularly long-term. There is emerging data about how modifiable risk factors for PDPH are not as absolute as once believed. There have been several new meta-analysis and clinical trials published, providing more data about effective therapies for PDPH. Significantly, much recent data has come out about the sequalae, particularly long-term of dural puncture. Emerging evidence demonstrates that in patients who are at low risk of PDPH, needle type and gauge may be of no consequence in a patient developing a PDPH. Although epidural blood patch (EBP) remains the gold-standard of therapy, several other interventions, both medical and procedural, show promise and may obviate the need for EBP in patients with mild-moderate PDPH. Patients who endure dural puncture, especially accidental dural puncture (ADP) are at low but significant risk of developing short term issues as well as chronic pain symptoms.