![]() This terminology has been officially adopted in the International Classification of Headache Disorders and is used in this section. Postural headaches following interventions that disrupt meningeal integrity are most commonly labeled postdural puncture headaches (PDPHs). Harrington and Miguel Angel Reina INTRODUCTION ![]() There is still limited evidence in literature about the understanding of PDPH and optimal treatment.Įpidural Epidural blood patch Positional headache Postdural puncture headache.Table of Contents Postdural Puncture Headacheīrian E. Further studies are essential to prove efficacy as well as safety over the proven treatment of epidural blood patches. Further less invasive treatments have been explored such as epidural saline, dextran 40 mg solutions, hydration, caffeine, sphenopalatine ganglion blocks, greater occipital nerve blocks, and surgical closure of the gap all have shown promise. For moderate-to-severe PDPH, epidural blood patch (EBP) remains the most effective treatment however, this invasive treatment is not without inherent risks. For mild PDPH, conservative treatments are currently focused around bed rest, as well as oral caffeine. Various prophylactic measures have been studied however, more studies have been recommended to be undertaken in order to establish a proven benefit. PDPH is a self-limiting postural headache that most often will resolve within 1 week, without need for treatment. The occurrence of PDPH can lead to increased patient morbidity, delayed discharge, and increased readmission. The overall incidence of PDPH after neuraxial procedures varies from 6 to 36%. PDPH is an adverse iatrogenic complication of neuraxial anesthesia that occurs following inadvertent puncture of the dura after epidural or spinal anesthesia. The purpose of this manuscript is to provide a comprehensive review of postdural puncture headache (PDPH) with a focus on epidemiology, pathophysiology, treatment, and prophylaxis.
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