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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.
A lumbar puncture can give the symptom of a post-dural-puncture headache. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. [5] A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak.
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 ...
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]
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]
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 ...
Types of epidural needles include: [3] The Crawford Needle; The Tuohy Needle; The Hustead Needle; The Weiss Needle; The Sprotte Spezial Needle; Other Epidural Needles : Other less popular types are the Wagner needle (1957), the Cheng needle(1958), the Crawley needle (1968), the Foldes needle (1973), and the Bell needle (1975)—all variants of the Huber design with a blunted tip of varying ...