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Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness .
It is estimated that the likelihood of a dural puncture occurring as a result of epidural catheter placement is 1.5%, with PDPH occurring in as much as 50% of these cases. [6] [3] Dural punctures usually present with a headache or backache within 3 days of the procedure. [13] The headache causes pain over the forehead and the back of the head.
The epidural syringe is filled with autologous blood and injected in the epidural space in order to close holes in the dura mater. The treatment of choice for this condition is the surgical application of epidural blood patches, [ 27 ] [ 79 ] [ 80 ] which has a higher success rate than conservative treatments of bed rest and hydration. [ 81 ]
Combined spinal and epidural anaesthesia in labouring women is associated with more pruritus if fentanyl (25 μg) is given intrathecally, than low-dose epidural analgesia. However, no difference has been found in the incidence of post dural puncture headache, requirement for epidural blood patch or maternal hypotension. [2]
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...
With chronic headache patients, the acupuncturist may needle "tender points at or near the site of maximal headache pain". [25] A study conducted by the University of North Carolina School of Medicine found that compared to medicinal treatment alone, medicinal treatment plus acupuncture resulted in more improvement for chronic daily headache ...
Treatment of chronic spinal injuries via the administration of mesenchymal stem cells, [8] either from adipose tissue or bone marrow, is experimental, with better results from the former method. Introduction of mesenchymal stem cells promote the microenvironment needed for axonal regrowth and reduction of inflammation caused by astrocytes ...
It is characteristically worse in the morning, generalized in character and throbbing in nature. It may be associated with nausea and vomiting. The headache can be made worse by any activity that further increases the intracranial pressure, such as coughing and sneezing. The pain may also be experienced in the neck and shoulders. [5]