Post dural puncture headache (PDPH)

Evidence-based neurology checklist on post dural puncture headache (pdph): Risk factors Use of traumatic needles: as against atraumatic needles Large needle size Inserting the bevel of the needle perpendicular to the direction of the nerve fibers Non-replacement of stylet before needle withdrawal…

Risk factors

  • Use of traumatic needles: as against atraumatic needles
  • Large needle size
  • Inserting the bevel of the needle perpendicular to the direction of the nerve fibers
  • Non-replacement of stylet before needle withdrawal
  • Repeated lumbar puncture (LP) attempts

Factors unrelated to risk of PDPH

Clinical features

Exacerbating features

Associated features

Prevention

Ineffective preventions

Cerebrospinal fluid (CSF): features

Magnetic resonance imaging (MRI)

Computed tomography (CT) myelogram

Established treatments

Emerging treatment

Treatments based on small trials and case reports

Synonym

References

  1. Ahmed SV, Jayawarna C, Jude E. Post lumbar puncture headache: diagnosis and management. Postgrad Med J 2006; 82:713-716.
  2. Turnbull DK, Shepherd DB. Post‐dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003; 91:718-729.
  3. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004; 24(Suppl 1):9–160.
  4. Muller B, Adelt K, Reichmann H, Toyka K. Atraumatic needle reduces the incidence of post-lumbar puncture syndrome. J Neurol 1994; 241:376-380.
  5. Evans RW, Armon C, Frohman EM, Goodin DS.  Assessment: prevention of post‐lumbar puncture headache. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2000; 55:909–914.
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