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Case 68 - A 30-Year-Old with Postural Headache 12 Hours after a Vaginal Delivery with Use of an Epidural

from Section 7 - Postpartum

Published online by Cambridge University Press:  08 April 2025

By
Ann Williford
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

A postdural puncture headache is the most common complication of neuraxial anesthesia. It results from leakage of cerebrospinal fluid at the dural puncture site and causes a positional headache within 72 hours of anesthesia placement. This case will cover the risk factors, diagnosis, and treatment. It will also discuss techniques for neuraxial anesthesia that may reduce the risk.

Keywords

postdural puncture headacheneuraxial anesthesia complicationsepidural blood patch
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 208 - 210
Publisher: Cambridge University Press
Print publication year: 2025

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References

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia. Obstet Gynecol. 2019;133:e208–e225.Google Scholar
Buddeberg, BS, Bandschapp, O, Girard, T. Post-dural Puncture Headache. Minerva Anesthesiol. 2019;85:543–553.Google ScholarPubMed
Basurto Ona, X, Osorio, D, Bonfill Cosp, X. Drug Therapy for Treating Post-dural Puncture Headache. Cochrane Database Syst Rev. 2015;(7):CD007887.CrossRefGoogle Scholar
Vallejo, MC, Zakowski, MI. Post-dural Puncture Headache Diagnosis and Management. Best Pract Res Clin Anaesthesiol. 2022;36(1):179–189.Google ScholarPubMed
Banks, S, Paech, M, Gurrin, L. An Audit of Epidural Blood Patch after Accidental Dural Puncture with a Tuohy Needle in Obstetric Patients. Int J Obstet Anesth. 2001;10:172.CrossRefGoogle ScholarPubMed
Kawaguchi, M, Hashizume, K, Watanabe, K, et al. Fluoroscopically Guided Epidural Blood Patch in Patients with Postdural Puncture Headaches after Spinal and Epidural Anesthesia. J Anesth. 2011;25:450.Google ScholarPubMed

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