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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.
This is known as second-half-of-the-day headache. This may be an initial presentation of a spontaneous CSF leak or appear after treatment such as an epidural patch, and likely indicates a slow spinal CSF leak. [30] While high CSF pressure can make lying down unbearable, low CSF pressure due to a leak can be relieved by lying flat on the back. [31]
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.
Moderate-to-severe cases can cause radicular pain in the legs caused by nerve root compression. [5] The symptoms are usually exacerbated by upright posture and often, but not always, relieved by lying down. Postural headaches can be related to spontaneous spinal cerebrospinal fluid leaks. [6] However, in many patients, dural ectasia is ...
Orthostatic headache is a medical condition in which a person develops a headache while vertical and the headache is relieved when horizontal. [1] [2] Previously it was often misdiagnosed as different primary headache disorders such as migraine or tension headaches. Increasing awareness of the symptom and its causes has prevented delayed or ...
When this condition occurs in the spinal canal, it is known as a spinal epidural hematoma. [4] There may be loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again. [2] Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. [1]
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The risk of headache and need for analgesia and blood patch is much reduced if "atraumatic" needles are used. This does not affect the success rate of the procedure in other ways. [18] [19] Although the cost and difficulty are similar, adoption remains low, at only 16% c. 2014. [20] The headaches may be caused by inadvertent puncture of the ...