title: Successful treatment of post-dural-puncture headache with surgical dura repair two years after spinal anesthesia.
abstract: BACKGROUND
  Post-dural-puncture headache (PDPH) can be a highly disturbing complication of elective spinal anesthesia. The incidence of PDPH when small needles are used is estimated to be 0%-14.5%. PDPH usually resolves spontaneously within a few days, but there are rare cases that persist in spite of conventional and epidural blood patch therapy.
  
  
  METHODS
  A 59-year-old man suffered from persistent postural headache for more than two years after an otherwise uneventful spinal anesthesia. Conventional and minimally invasive treatments were unsuccessful.
  
  
  RESULTS
  A neurosurgical procedure was performed, during which a dural leak was identified and repaired. The patient was immediately pain free after surgery and has remained so for the duration of follow-up (more than one year).
authors.affiliation: Pain Relief Unit, Department of Anesthesia and Intensive Care Medicine, Basel, Switzerland.
authors.forename: Christos D
authors.initials: CD
authors.lastname: Pouskoulas
authors.forename: Ethan
authors.initials: E
authors.lastname: Taub
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Ruppen
mesh_terms: D000775:Anesthesia, Spinal / Q000009:adverse effects; D004388:Dura Mater / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D051299:Post-Dural Puncture Headache / Q000601:surgery*; D013129:Spinal Puncture / Q000009:adverse effects*; D013997:Time Factors
keywords: Post-dural-puncture headache; blood patch; dura repair; radionuclide cisternography