Post-dural puncture headaches in children. A literature review.
Post-dural puncture headache (PDPH) is a well recognised complication of spinal and epidural anaesthesia. It can also occur after diagnostic or therapeutic lumbar puncture. Few cases have been reported in children. We reviewed the literature regarding definition, aetiology, incidence, risk factors, prevention and treatment, in order to provide some recommendations. Significant factors include age, gender, needle diameter, needle tip design, orientation of the tip during puncture, previous PDPH, history of migraine and repeated attempts to achieve puncture. There is no evidence for the use of increased fluids or bed rest to prevent PDPH. Once the diagnosis is made, conservative therapy is recommended for 48 h. Persistent PDPH can be treated in several ways; an epidural blood patch is one of the most effective methods.


CONCLUSIONS
occurrence of post-dural puncture headache after lumbar puncture in children is rare. There are conflicting data about risk factors, prevention and treatment.
Janssens
Elke
E
Department of Paediatrics, Catholic University of Leuven, Leuven, Belgium.
Aerssens
Peter
P
Paediatric Department, Virga Jesseziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium.
Alliët
Phillipe
P
Paediatric Department, Virga Jesseziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium.
Gillis
Phillipe
P
Paediatric Department, Virga Jesseziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium.
Raes
Marc
M
Paediatric Department, Virga Jesseziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium. dr.raes.marc@wanadoo.be.
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D017217:Blood Patch, Epidural; D002648:Child; D006261:Headache / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D012307:Risk Factors; D013129:Spinal Puncture / Q000009:adverse effects*