Related Experiment Video
Updated: Apr 5, 2026
06:18
A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
9.7K
Postdural puncture headache and epidural blood patch use in elderly patients
Sari Sjövall1, Merja Kokki2, Eetu Turunen2
1Department of Anesthesia, Satakunta Central Hospital, Satakunnan keskussairaala Sairaalantie 3, FI-28500 Pori, Finland.
Journal of Clinical Anesthesia
|August 20, 2015
Summary
Postdural puncture headache can occur in elderly patients. Epidural blood patch is an effective and safe treatment for severe symptoms in this population, offering significant relief.
Area of Science:
- Anesthesiology
- Neurology
- Geriatrics
Background:
- Postdural puncture headache (PDPH) is a recognized complication following lumbar puncture.
- PDPH is considered rare in elderly patients, with limited literature on epidural blood patch (EBP) use in this demographic.
Purpose of the Study:
- To evaluate the efficacy and safety of epidural blood patch (EBP) for treating postdural puncture headache (PDPH) in patients aged 65 years and older.
Main Methods:
- Retrospective study conducted across two tertiary and one secondary hospital in Finland.
- Data collected from patients aged 65+ who underwent EBP between 2000 and 2011.
- Medical records reviewed for demographics, lumbar puncture details, PDPH symptoms, conservative treatments, and EBP outcomes.
Main Results:
- Forty elderly patients (65-82 years) received EBP for PDPH.
- EBP provided complete and persistent symptom relief in 85% of patients.
- Minor symptom relief or no relief occurred in 10% of patients, who then received conservative treatment.
Conclusions:
- Elderly individuals are susceptible to postdural puncture headache.
- Epidural blood patch is an effective and well-tolerated therapeutic option for persistent and severe PDPH in the elderly.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
969
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
969
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
813
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
813
01:30Epistaxis
740
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
740
01:15Drug Dosing: Geriatric Patients
357
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
357
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
325
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
325
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
672
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
672