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Post‐Dural Puncture Headache: Part II – Prevention,Management, and Prognosis
Authors:David Bezov MD  Sait Ashina MD  Richard Lipton MD
Affiliation:1. From the Neurology, Montefiore Hospital, Bronx, NY, USA (D. Bezov);2. Neurololgy, Albert Einstein College of Medicine, Bronx, NY, USA (S. Ashina and R. Lipton).
Abstract:Post‐dural puncture headache (PDPH) is a frequent complication of lumbar puncture, performed for diagnostic or therapeutic purposes or accidentally, as a complication of epidural anesthesia. As PDPH can be disabling, clinicians who perform these procedures should be familiar with strategies for preventing this disorder. Since the best preventative measures sometimes fail, clinicians should also be familiar with the therapeutic approaches for PDPH. Herein, we review the procedure‐related risk factors for PDPH, the prognosis of PDPH and the studies of PDPH treatment. We divide the therapeutic approach to PDPH into 4 stages: conservative management, aggressive medical management, conventional invasive treatments, and the very rarely employed less conventional invasive treatments and provide management algorithm to facilitate treatment.
Keywords:post‐dural puncture headache prevention  post‐dural puncture treatment  post‐dural puncture prognosis
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