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2017 ; 70
(2
): 136-143
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Postdural puncture headache
#MMPMID28367283
Kwak KH
Korean J Anesthesiol
2017[Apr]; 70
(2
): 136-143
PMID28367283
show ga
Postdural puncture headache (PDPH) is a common complication after inadvertent
dural puncture. Risks factors include female sex, young age, pregnancy, vaginal
delivery, low body mass index, and being a non-smoker. Needle size, design, and
the technique used also affect the risk. Because PDPH can be incapacitating,
prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a
postural headache that worsens with sitting or standing, and improves with lying
down. Conservative therapies such as bed rest, hydration, and caffeine are
commonly used as prophylaxis and treatment for this condition; however, no
substantial evidence supports routine bed rest and aggressive hydration. An
epidural blood patch is the most effective treatment option for patients with
unsuccessful conservative management. Various other prophylactic and treatment
interventions have been suggested. However, due to a lack of conclusive evidence
supporting their use, the potential benefits of such interventions should be
weighed carefully against the risks. This article reviews the current literature
on the diagnosis, risk factors, pathophysiology, prevention, and treatment of
PDPH.