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Updated: Aug 7, 2026
05:40
Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache
Published on: July 29, 2021
Persistent post-dural-puncture headache treated with epidural infusion of dextran
1Center for Pain Management, Destin, FL 32541.
Headache
|May 1, 1994
Summary
Persistent post-dural-puncture headaches, even after epidural blood patches, were effectively treated with dextran-40. This innovative therapy provided rapid relief for patients suffering from severe headaches.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Post-dural-puncture headache (PDPH) is a potential complication following neuraxial procedures.
- Persistent PDPH can significantly impact patient recovery and quality of life.
- Conventional treatments, including epidural blood patches (EBPs), are not always successful.
Purpose of the Study:
- To evaluate the efficacy of dextran-40 in treating persistent post-dural-puncture headaches.
- To assess a novel treatment approach for refractory PDPH cases.
Main Methods:
- Retrospective review of 13 patients with persistent PDPH despite prior treatments.
- Treatment involved an initial bolus of dextran-40 followed by a continuous epidural infusion.
- Catheter insertion via lumbar or caudal approaches was utilized.
Main Results:
- All 13 patients experienced complete headache resolution within 20 hours (mean 9.55 hours).
- Five patients reported symptom relief in under 5 hours.
- Associated symptoms like nausea and photophobia resolved earlier.
Conclusions:
- Continuous epidural infusion of dextran-40 is a highly effective treatment for persistent PDPH.
- This method offers rapid and successful relief for patients refractory to conventional therapies like EBPs.
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