Am Fam Physician. 2024;110(1):97-98
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Postdural puncture headache should be suspected with any headache or neurologic symptoms occurring within 5 days of a neuraxial procedure.
• Initial treatment for a postdural puncture headache should include regular analgesics and caffeine.
• Epidural blood patches are recommended when postdural puncture headaches impair daily living or are associated with neurologic symptoms despite conservative therapy.
From the AFP Editors
Postdural puncture headache is caused by low cerebrospinal fluid pressure that occurs within 5 days of an accidental or intentional lumbar puncture. A multisociety, international working group released guidelines on the evaluation and treatment of postdural puncture headache.
WHEN TO SUSPECT POSTDURAL PUNCTURE HEADACHE
Postdural puncture headache should be suspected anytime a headache or neurologic symptoms occur within 5 days of a neuraxial procedure. Typical symptoms include neck stiffness; pain in the cervical, thoracic, or lumbar spine; subjective hearing symptoms; visual disturbances; and vertigo. Symptoms most often improve when lying flat. Headaches, which are common after childbirth, are only sometimes due to postdural puncture.
Subscribe
From $165- Immediate, unlimited access to all AFP content
- More than 130 CME credits/year
- AAFP app access
- Print delivery available
Issue Access
$59.95- Immediate, unlimited access to this issue's content
- CME credits
- AAFP app access
- Print delivery available
