A 38-year-old gravida 7 para 5 Hispanic woman at 36 weeks and 4 days gestation presented with a postpartum headache following vaginal delivery complicated by an unintentional dural puncture for epidural analgesia. Due to the positional nature of the headache and its frontal and occipital origin, a postdural puncture headache was diagnosed. After failure of conservative treatment, an epidural bl...

A 29-YR-OLD healthy parturient developed positional frontoparietalheadacheafteraccidentalduralpuncture during attempted placement of an epidural catheter. The headache improved with hydration, bed rest, and analgesics. However, it persisted (without postural component) at the 2week interval. Neurologic examination was normal. Magnetic resonance imaging showed the presence of bilateral frontopar...

The developments of new spinal needles and needle tip designs have reduced the incidence of postdural puncture headache (PDPH). Although it is clear that reducing the loss of CSF leak from dural puncture reduces the headache, there are areas regarding the pathogenesis, treatment, and prevention of PDPH that remain controversial. Air travel by itself may impose physiological alteration in centra...

Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge ...

conclusions conservative management is successful in the vast majority of patients with spinal headache. interventional procedures are required in a small fraction of patients for symptomatic relief. case presentation intrathecal drug delivery system (idds) was initially used for the management of chronic malignant pain; it has since been used to manage pain from other nonmalignant conditions a...