Ever since the first spinal anesthetic in the late 19th century, the problem of "spinal headache" or post-dural puncture headache (PDPH) has plagued clinicians, and more importantly, patients. It has long been realized that the headache and other symptoms that often occur after the entry of a needle into the subarachnoid space is somehow related to fluid loss, although the exact pathophysiology...

Post-Spinal Headache: A New Possible Pathophysiology Ali Shahriari, and Mahdi Sheikh Department of Anesthesiology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Corresponding author: Ali Shahriari, Department of Anesthesiology, Roozbeh Hospital, Tehran University of Medical ...

Treatment of postdural puncture headaches involves oral or intravenous (IV) fluid or caffeine-containing analgesics, micro-catheterization of spinal space, epidural administration of blood obtained from the patient, or epidural blood patch and fiberoptic imaging-guided epidural interventional techniques. Epidural blood patch is, to date, the most effective treatment, but it is an invasive proce...

August Bier’s first report of spinal anesthesia in August 1898 impressively described the development of a poste dural puncture headache (PDPH) (1). When asked for complications of spinal anesthesia today, patients often respond with PDPH. PDPH is defined as a constant heado ache that worsens in the sitting or upright position folglowing lumbar puncture (LP). Its incidence after spinal anesthes...

Hospital Physician June 2007 51 Lumbar puncture is a common procedure performed for diagnostic, anesthetic, and obstetric purposes; however, up to one third of patients may experience headache after the procedure.1,2 In 1898, Bier was the first to report on post–lumbar puncture headache (PLPH) after he and his associates underwent lumbar puncture themselves and experienced headaches first-hand....

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 ...

The problem was analyzed and the pathophysiology of post-dural puncture headache highlighted. Clinical manifestations, risk factors diagnosis this complication are given. Modern methods for treatment described. own experience on prevention made public with conclusion that when using Ball-Pen needles, only 12 (0.56 %) 2125 patients complained hea­dache, which is 12.5 times less than average stat...

Post-dural puncture headache (PDPHA) has been a vexing problem for patients undergoing dural puncture for spinal anaesthesia, as a complication of epidural anaesthesia, and after diagnostic lumbar puncture since Bier reported the first case in 1898. This Chapter discusses the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to th...