post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors

post spinal puncture headache (psph) is a well known complication of spinal anesthesia. it occurs after spinal anesthesia induction due to dural and arachnoid puncture and has a significant effect on the patient’s postoperative well being. this manuscript is based on an observational study that runs on babol university of medical sciences and review of literatures about current concepts about the incidence, risk factors and predisposing factors of post spinal puncture headache.the overall incidence of post-dural puncture headache after intentional dural puncture varies form 0.1-36%, while it is about 3.1% by atraumatic spinal needle 25g whitacre. 25g quincke needle with a medium bevel cutting is popular with widespread use and the incidence of psph is about 25%, but its incidence obtained 17.3% by spinal needle 25g quincke in our observation. the association of predisposing factors like female, young age, pregnancy, low body mass index, multiple dural puncture, inexpert operators and past medical history of chronic headache, expose the patient to psph. the identification of factors that predict the likelihood of psph is important so that measures can be taken to minimize this painful complication resulting from spinal anesthesia.