Table of Contents Author Guidelines Submit a Manuscript
Anesthesiology Research and Practice
Volume 2010, Article ID 102967, 6 pages
Review Article

Postdural Puncture Headache

Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 515, Little Rock, AR 72205, USA

Received 10 February 2010; Accepted 2 July 2010

Academic Editor: Girish P. Joshi

Copyright © 2010 Ahmed Ghaleb. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24–48 h of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications of AEBP are rare.