Relief of post-lumbar puncture headache with epidural dextran 40: a preliminary report

Fifty-six adult patients who developed post-lumbar puncture headache (PLPH) were treated with epidural Dextran 40 after various therapeutic measures, such as rest, intravenous fluids, narcotic as well as non-narcotic analgesics, epidural injection of saline, oral steroids, acupuncture, and applications of blood patch at the puncture site, had proven unsatisfactory. An average of 20 ml dextran was injected epidurally over a period of 120 seconds with patients in the sitting or lateral decubitus position. Relief of headache was accomplished in all patients after periods ranging from 15 minutes to 24 hours. Follow-up 6 months to 1 year revealed no recurrence of the headache. Burning sensation at the injection site and dysesthesia at the time of injection were noted in 3.5% and 7.1% of patients, respectively.