Update and Advances on Post-dural Puncture Headache

Robert Bishop; Amy Chen; William Derois Yates; Julie Fowler; Stephen Macres

doi:10.1016/j.aan.2023.05.005

Update and Advances on Post-dural Puncture Headache

Adv Anesth. 2023 Dec;41(1):71-85. doi: 10.1016/j.aan.2023.05.005. Epub 2023 Aug 1.

Authors

Robert Bishop¹, Amy Chen², William Derois Yates², Julie Fowler², Stephen Macres²

Affiliations

¹ Department of Anesthesiology & Pain Medicine, UC Davis Medical Center, 4150 V Street, PSSB Suite 1200, Sacramento, CA 95817, USA. Electronic address: rbishop@ucdavis.edu.
² Department of Anesthesiology & Pain Medicine, UC Davis Medical Center, 4150 V Street, PSSB Suite 1200, Sacramento, CA 95817, USA.

PMID: 38251623
DOI: 10.1016/j.aan.2023.05.005

Abstract

This document provides an overview of post-dural puncture headache (PDPH), covering its historical perspective, anatomy and physiology of cerebrospinal fluid (CSF), pathophysiology, risk factors, diagnosis, and treatment options. PDPH is a common complication of dural puncture, characterized by a postural headache due to CSF leakage. The understanding of CSF and dural anatomy has evolved over time, leading to advancements in diagnosing and managing PDPH. Treatment options range from conservative measures to epidural blood patch, intrathecal catheter, and regional techniques like sphenopalatine ganglion block and greater occipital nerve block. Further research is needed to optimize treatment approaches and improve patient outcomes.

Keywords: Cerebrospinal fluid; Dural puncture; Epidual blood patch; Occipital nerve block; Sphenopalatine nerve block.

Published by Elsevier Inc.

Publication types

Review

MeSH terms

Anesthesia, Conduction*
Blood Patch, Epidural
Headache
Humans
Post-Dural Puncture Headache* / diagnosis
Post-Dural Puncture Headache* / etiology
Post-Dural Puncture Headache* / therapy
Punctures