title: Post-dural puncture headache.
abstract: Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH) has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are 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 < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24-48 hours of dural puncture. The optimum volume of blood has been shown to be 12-20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP) are rare.
authors.affiliation: Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ghaleb
authors.forename: Arjang
authors.initials: A
authors.lastname: Khorasani
authors.forename: Devanand
authors.initials: D
authors.lastname: Mangar