Related Experiment Video
Updated: Aug 8, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Postdural puncture headache
1Pharmacology, Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. gaiserr@uphs.upenn.edu
Current Opinion in Anaesthesiology
|June 1, 2006
Summary
Postdural puncture headache is a common complication of neuraxial anesthesia. An epidural blood patch is the preferred treatment, ideally performed 24 hours after dural puncture for optimal success.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Postdural puncture headache (PDPH) is the most frequent complication following neuraxial anesthesia.
- It can arise from both uncomplicated spinal anesthesia and unintended dural punctures during epidural anesthesia.
Purpose of the Study:
- To review the incidence, prevention, and treatment of postdural puncture headache.
- To evaluate current strategies for managing PDPH after spinal and epidural anesthesia.
Main Methods:
- Review of current literature on postdural puncture headache.
- Analysis of preventative measures, including intrathecal catheters.
- Evaluation of therapeutic interventions, focusing on medications and epidural blood patch.
Main Results:
- The incidence of PDPH after accidental dural puncture is approximately 50%.
- Intrathecal catheters show promise in preventing PDPH by sealing the dural hole.
- Epidural blood patch is the gold standard treatment, with medications like methylergonovine maleate also considered.
Conclusions:
- Epidural blood patch efficacy is maximized when performed 24 hours post-dural puncture.
- Prompt treatment is crucial for symptomatic patients to minimize suffering duration.
Related Concept Videos
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...