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...

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...

Indian Journal of Anaesthesia | Vol. 60 | Issue 10 | Oct 2016 782 Oral Med Oral Pathol Oral Radiol 2013;115:46‐55. 4. Bufalino A, Paranaíba LM, Gouvêa AF, Gueiros LA, Martelli‐Júnior H, Junior JJ, et al. Cleidocranial dysplasia: Oral features and genetic analysis of 11 patients. Oral Dis 2012;18:184‐90. 5. Almenrader N, Passariello M, Cascone P. Anaesthesia for a child with cleidocranial dyspla...

OBJECTIVE To compare the ease of use of atraumatic needles with standard needles for diagnostic lumbar puncture and the incidence of headache after their use. DESIGN Double blind, randomised controlled trial. SETTING Investigation ward of a neurology unit in a university hospital. PARTICIPANTS 116 patients requiring elective diagnostic lumbar puncture. INTERVENTIONS Standardised protoco...

CLINICAL QUESTION Is lumbar puncture still needed in suspected subarachnoid hemorrhage with a negative head computed tomographic scan performed within 6 hours of headache onset? ARTICLE CHOSEN Perry JJ, Stiell IG, Sivilotti ML, et al. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011...

Superior sagittal sinus (SSS) obstruction causes intracranial hypertension, often requiring surgical stenting. Consensus on treating brain venous stenosis, another cause, is lacking. This study reports a case of SSS stenosis and hypertension treated with stenting, improving bilateral papilledema. A 51-year-old headache visual disturbance had papilledema field loss. MR venography showed leading ...

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 ...