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Post-dural-puncture headache

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Using a pencil point rather than a cutting spinal needle decreases the risk. The size of the pencil point needle does not appear to make a difference, while smaller cutting needles have a low risk compared to larger ones. Modern, atraumatic needles such as the Sprotte or Whitacre spinal needle leave
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Using a pencil-point needle rather than a cutting spinal needle decreases the risk of developing PDPH. Smaller needle gauges decrease the odds of PDPH, but make it more challenging to perform the procedure successfully. The needle with the lowest PDPH rate and highest succession rate is the 26G
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a smaller perforation and reduce the risk for PDPH. However, the evidence that atraumatic needles reduce the risk of post-dural puncture headache (PDPH) without increasing adverse events such as paraesthesia or backache is moderate-quality and further research should be done.
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Abdelaal Ahmed Mahmoud, Ahmed; Mansour, Amr Zaki; Yassin, Hany Mahmoud; Hussein, Hazem Abdelwahab; Kamal, Ahmed Moustafa; Elayashy, Mohamed; Elemady, Mohamed Farid; Elkady, Hany W.; Mahmoud, Hatem Elmoutaz; Cusack, Barbara; Hosny, Hisham (2018-12-01).
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that typically worsen when the patient assumes an upright posture. The headache usually occurs 24–48 hours after puncture but may occur as many as 12 days after. It usually resolves within a few days but has been rarely documented to take much longer.
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causes reduced fluid pressure in the brain and spinal cord. Onset occurs within two days in 66% of cases and three days in 90%. It occurs so rarely immediately after puncture that other possible causes should be investigated when it does.
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Estimates for the overall incidence of PDPH vary between 0.1% and 36%. It is more common in younger patients (especially in the 18–30 age group), females (especially those who are pregnant), and those with a low
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EBP is effective, and further intervention is rarely necessary. 25–35% of patients suffer from transient back pain after EBP. More rare complications of EBP include misplacement of blood leading to spinal
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Although in very rare cases the headache may present immediately after a puncture, this is almost always due to another cause such as increased intracranial pressure and requires immediate attention.
1725: 288:(BMI). The low prevalence in elderly patients may be due to a less stretchable dura mater. It is also more common with the use of larger diameter needles. A 2006 review reported an incidence of: 596:
Zorrilla-Vaca A, Mathur V, Wu CL, Grant MC (July 2018). "The Impact of Spinal Needle Selection on Postdural Puncture Headache: A Meta-Analysis and Metaregression of Randomized Studies".
89:). The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving 1642: 1767: 1048:"The Effectiveness of Bilateral Greater Occipital Nerve Block by Ultrasound for Treatment of Post-Dural Puncture Headache in Comparison with Other Conventional Treatment" 1633: 639:
Arevalo-Rodriguez I, Muñoz L, Godoy-Casasbuenas N, Ciapponi A, Arevalo JJ, Boogaard S, RoquĂ© I, Figuls M, et al. (Cochrane Anaesthesia Group) (April 2017).
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Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas, Natalia; Ciapponi, Agustín; Arevalo, Jimmy J; Boogaard, Sabine; Roqué i Figuls, Marta (2017-04-07).
93:. It is exacerbated by movement and sitting or standing and is relieved to some degree by lying down. Nausea, vomiting, pain in arms and legs, hearing loss, 1087:
Jespersen, Mads S.; Jaeger, Pia; Ægidius, Karen L.; Fabritius, Maria L.; Duch, Patricia; Rye, Ida; Afshari, Arash; Meyhoff, Christian S. (2020-04-15).
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PDPH is roughly twice as common in lumbar puncture than spinal anaesthesia, almost certainly due to the atraumatic needles used in spinal anaesthesia.
837:"Meningeal (postdural) puncture headache, unintentional dural puncture, and the epidural blood patch: a national survey of United States practice" 206:
appear effective in reducing post dural puncture headaches. Evidence does not support the use of bed rest or intravenous fluids to prevent PDPH.
548:"The association between post-dural puncture headache and needle type during spinal anaesthesia: a systematic review and network meta-analysis" 1379:"Facial nerve paralysis and partial brachial plexopathy after epidural blood patch: a case report and review of the literature" 1007:"Is theophylline more effective than sumatriptan in the treatment of post-dural puncture headache? A randomized clinical trial" 952:"Addition of Neostigmine and Atropine to Conventional Management of Postdural Puncture Headache: A Randomized Controlled Trial" 1179:"Delayed radicular pain following two large volume epidural blood patches for post-lumbar puncture headache: a case report" 1616: 1089:"Sphenopalatine ganglion block for the treatment of postdural puncture headache: a randomised, blinded, clinical trial" 33:
Post-spinal-puncture headache, post-lumbar-puncture headache, spinal headache, epidural headache, low-pressure headache
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Mostafa Mohamed Stohy, El-Sayed; Mohamed Mohamed El-Sayed, Mostafa; Saeed Mohamed Bastawesy, Mohamed (2019-10-01).
338:"Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors" 233:. Minimally invasive procedures as; bilateral greater occipital nerve block or sphenopalatine ganglion block. 1862: 1748: 1710: 1655: 295:
40% if a needle between 0.7176 mm (0.02825 in) and 0.9081 mm (0.03575 in) is used; and
1830: 1438:"An epidural blood patch causing acute neurologic dysfunction necessitating a decompressive laminectomy" 292:
12% if a needle between 0.4128 mm (0.01625 in) and 0.5652 mm (0.02225 in) is used;
1045: 1882: 1577: 892:"Comparing the effect of pregabalin, gabapentin, and acetaminophen on post-dural puncture headache" 298:
70% if a needle between 1.067 mm (0.0420 in) and 1.651 mm (0.0650 in) is used.
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Pharmacological treatments as; gabapentin, pregabalin, neostigmine/atropine, methylxanthines, and
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Safa-Tisseront V, Thormann F, Malassiné P, Henry M, Riou B, Coriat P, Seebacher J (August 2001).
1877: 1867: 1685: 1609: 261: 272: 1903: 1852: 1738: 1277:"Intrathecal injection of epidural blood patch: a case report and review of the literature" 237: 159: 688:
Basurto Ona X, Uriona Tuma SM, MartĂ­nez GarcĂ­a L, SolĂ  I, Bonfill Cosp X (February 2013).
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is injected into the epidural space near the site of the original puncture; the resulting
8: 1857: 1733: 1566: 1130:"Effectiveness of epidural blood patch in the management of post-dural puncture headache" 737:
Arevalo-Rodriguez I, Ciapponi A, Roqué i Figuls M, Muñoz L, Bonfill Cosp X (March 2016).
151: 117: 1332:"A subdural abscess and infected blood patch complicating regional analgesia for labour" 1929: 1473: 1413: 1378: 1312: 1159: 987: 926: 872: 812: 787: 763: 738: 714: 689: 665: 640: 621: 523: 490: 416: 391: 354: 337: 163: 48: 1571: 891: 133:
PDPH typically occurs hours to days after puncture and presents with symptoms such as
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Maranhao, B.; Liu, M.; Palanisamy, A.; Monks, D. T.; Singh, P. M. (August 2021).
491:"Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)" 285: 109: 890:
Mahoori, Alireza; Noroozinia, Heydar; Hasani, Ebrahim; Saghaleini, Hadi (2014).
1872: 1802: 1715: 1347: 1228:"Spinal subdural haematoma as a complication of immediate epidural blood patch" 638: 488: 155: 90: 1292: 1105: 1088: 1923: 1461: 1404: 1355: 1300: 1253: 1204: 1073: 1032: 975: 917: 908: 860: 571: 514: 407: 203: 1509: 1492: 1437: 1331: 1276: 1064: 1047: 836: 736: 547: 336:
Jabbari A, Alijanpour E, Mir M, Bani Hashem N, Rabiea SM, Rupani MA (2013).
1518: 1469: 1422: 1363: 1308: 1212: 1155: 1114: 983: 935: 868: 821: 772: 723: 674: 617: 579: 532: 475: 425: 363: 102: 1261: 948: 687: 466: 449: 268: 199: 86: 1542: 1898: 1784: 1395: 1244: 1227: 563: 265: 245: 78: 450:"Post-dural puncture headache: pathogenesis, prevention and treatment" 226:. Vigorous hydration is routinely encouraged in postpartum patients. 215: 39: 1491:
Alstadhaug KB, Odeh F, Baloch FK, Berg DH, Salvesen R (April 2012).
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pencil-point needle. Its estimated PDPH rate is between 2% and 10%.
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Shaat, Ahmed Mohamed; Abdalgaleil, Mohamed Mahmoud (2021-01-01).
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Mehta, Sonya P.; Keogh, Bart P.; Lam, Arthur M. (January 2014).
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Tekkök, Ismail H.; Carter, David A.; Brinker, Ray (1996-03-01).
739:"Posture and fluids for preventing post-dural puncture headache" 1554: 1086: 335: 222:. A 2015 review found tentative evidence to support the use of 138: 1275:
Kalina, Peter; Craigo, Paula; Weingarten, Toby (August 2004).
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Desai, Mehul J.; Dave, Ankur P.; Martin, Megan B. (May 2010).
785: 241: 82: 306:, these correspond to the values 27–24G, 22–20G and 19–16G. 1594: 835:
Harrington, Brian E.; Schmitt, Andrew M. (September 2009).
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or intrathecal injection and arachnoiditis, infection with
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Common side effect of lumbar puncture or spinal anaesthesia
690:"Drug therapy for preventing post-dural puncture headache" 595: 545: 392:"Post lumbar puncture headache: diagnosis and management" 1490: 788:"Drug therapy for treating post-dural puncture headache" 1274: 786:
Basurto Ona X, Osorio D, Bonfill Cosp X (July 2015).
1532: 1225: 389: 834: 1921: 1004: 447: 1377:Shahien, Radi; Bowirrat, Abdalla (2011-02-02). 1376: 1176: 390:Ahmed SV, Jayawarna C, Jude E (November 2006). 443: 441: 439: 437: 435: 137:(which is mostly bi-frontal or occipital) and 1610: 1435: 1336:International Journal of Obstetric Anesthesia 1329: 1121: 214:Some people require no other treatment than 1330:Collis, R. E.; Harries, S. E. (July 2005). 792:The Cochrane Database of Systematic Reviews 743:The Cochrane Database of Systematic Reviews 694:The Cochrane Database of Systematic Reviews 645:The Cochrane Database of Systematic Reviews 495:The Cochrane Database of Systematic Reviews 432: 1617: 1603: 448:Turnbull DK, Shepherd DB (November 2003). 236:Persistent and severe PDPH may require an 38: 1508: 1412: 1394: 1243: 1194: 1145: 1104: 1063: 1022: 925: 907: 811: 762: 713: 664: 591: 589: 522: 465: 415: 353: 331: 329: 327: 325: 323: 321: 178: 150:PDPH is thought to result from a loss of 1497:Tidsskrift for den Norske Laegeforening 77:) is a complication of puncture of the 1922: 586: 318: 1598: 1442:Regional Anesthesia and Pain Medicine 841:Regional Anesthesia and Pain Medicine 598:Regional Anesthesia and Pain Medicine 128: 385: 383: 381: 379: 377: 375: 373: 342:Caspian Journal of Internal Medicine 248:then "patches" the meningeal leak. 13: 145: 14: 1941: 1528: 370: 240:. A small amount of the person's 81:(one of the membranes around the 1147:10.1097/00000542-200108000-00012 108:PDPH is a common side effect of 47:PDPH is a common side effect of 1493:"Post-lumbar puncture headache" 1484: 1429: 1370: 1323: 1268: 1232:Canadian Journal of Anaesthesia 1219: 1170: 1080: 1039: 1011:Egyptian Journal of Anaesthesia 998: 942: 883: 828: 779: 278: 1093:British Journal of Anaesthesia 804:10.1002/14651858.CD007887.pub3 755:10.1002/14651858.CD009199.pub3 730: 706:10.1002/14651858.cd001792.pub3 681: 657:10.1002/14651858.CD010807.pub2 632: 539: 507:10.1002/14651858.CD010807.pub2 482: 454:British Journal of Anaesthesia 166:then leads to traction to the 105:of the scalp are also common. 1: 1863:External compression headache 1749:New daily persistent headache 1711:Chronic paroxysmal hemicrania 1024:10.1080/11101849.2021.1949195 312: 186: 1808:Post-dural-puncture headache 1624: 1454:10.1097/AAP.0000000000000025 968:10.1213/ANE.0000000000003734 896:Saudi Journal of Anaesthesia 853:10.1097/AAP.0b013e3181b493e9 610:10.1097/AAP.0000000000000775 396:Postgraduate Medical Journal 209: 173: 71:Post-dural-puncture headache 25:Post-dural-puncture headache 7: 1831:Medication overuse headache 10: 1946: 1348:10.1016/j.ijoa.2005.03.002 956:Anesthesia & Analgesia 170:with associated symptoms. 1891: 1843: 1816: 1793: 1775: 1766: 1724: 1696: 1671: 1641: 1632: 1536: 1293:10.1007/s10140-004-0365-0 1106:10.1016/j.bja.2020.02.025 58: 46: 37: 29: 24: 1383:Journal of Pain Research 1196:10.36076/ppj.2010/13/257 1052:Al-Azhar Medical Journal 909:10.4103/1658-354X.136436 408:10.1136/pgmj.2006.044792 1510:10.4045/tidsskr.11.0832 1065:10.21608/amj.2019.64954 1878:Postherpetic neuralgia 1868:Cold-stimulus headache 1686:Mixed tension migraine 262:facial nerve paralysis 179:Differential diagnosis 273:cauda equina syndrome 1883:Tolosa–Hunt syndrome 1853:Trigeminal neuralgia 1739:Thunderclap headache 238:epidural blood patch 160:hydrostatic pressure 1858:Occipital neuralgia 1734:Hemicrania continua 1656:Familial hemiplegic 1281:Emergency Radiology 152:cerebrospinal fluid 118:cerebrospinal fluid 1396:10.2147/JPR.S15314 1245:10.1007/BF03011749 564:10.1111/anae.15320 467:10.1093/bja/aeg231 164:subarachnoid space 129:Signs and symptoms 49:spinal anaesthesia 1917: 1916: 1839: 1838: 1762: 1761: 1592: 1591: 254:subdural hematoma 114:spinal anesthesia 68: 67: 19:Medical condition 1937: 1773: 1772: 1663:Retinal migraine 1639: 1638: 1619: 1612: 1605: 1596: 1595: 1558:: G44.820, G97.0 1534: 1533: 1523: 1522: 1512: 1488: 1482: 1481: 1433: 1427: 1426: 1416: 1398: 1374: 1368: 1367: 1327: 1321: 1320: 1272: 1266: 1265: 1247: 1223: 1217: 1216: 1198: 1174: 1168: 1167: 1149: 1125: 1119: 1118: 1108: 1084: 1078: 1077: 1067: 1043: 1037: 1036: 1026: 1002: 996: 995: 962:(6): 1434–1439. 946: 940: 939: 929: 911: 887: 881: 880: 832: 826: 825: 815: 783: 777: 776: 766: 734: 728: 727: 717: 685: 679: 678: 668: 651:(12): CD010807. 636: 630: 629: 593: 584: 583: 558:(8): 1098–1110. 543: 537: 536: 526: 486: 480: 479: 469: 445: 430: 429: 419: 387: 368: 367: 357: 333: 304:Birmingham gauge 258:subdural abscess 216:pain medications 101:, dizziness and 42: 22: 21: 1945: 1944: 1940: 1939: 1938: 1936: 1935: 1934: 1920: 1919: 1918: 1913: 1887: 1835: 1812: 1789: 1758: 1754:Hypnic headache 1744:Sexual headache 1720: 1692: 1667: 1628: 1623: 1593: 1588: 1587: 1545: 1531: 1526: 1489: 1485: 1434: 1430: 1375: 1371: 1328: 1324: 1273: 1269: 1224: 1220: 1175: 1171: 1126: 1122: 1085: 1081: 1044: 1040: 1003: 999: 947: 943: 888: 884: 833: 829: 798:(7): CD007887. 784: 780: 749:(4): CD009199. 735: 731: 700:(2): CD001792. 686: 682: 637: 633: 594: 587: 544: 540: 501:(4): CD010807. 487: 483: 446: 433: 388: 371: 334: 319: 315: 286:body mass index 281: 212: 189: 181: 176: 148: 146:Pathophysiology 131: 110:lumbar puncture 64:Anaesthesiology 20: 17: 12: 11: 5: 1943: 1933: 1932: 1915: 1914: 1912: 1911: 1906: 1901: 1895: 1893: 1889: 1888: 1886: 1885: 1880: 1875: 1873:Optic neuritis 1870: 1865: 1860: 1855: 1849: 1847: 1841: 1840: 1837: 1836: 1834: 1833: 1828: 1822: 1820: 1814: 1813: 1811: 1810: 1805: 1803:Ictal headache 1799: 1797: 1791: 1790: 1788: 1787: 1781: 1779: 1770: 1764: 1763: 1760: 1759: 1757: 1756: 1751: 1746: 1741: 1736: 1730: 1728: 1722: 1721: 1719: 1718: 1713: 1708: 1702: 1700: 1694: 1693: 1691: 1690: 1689: 1688: 1677: 1675: 1669: 1668: 1666: 1665: 1660: 1659: 1658: 1647: 1645: 1636: 1630: 1629: 1622: 1621: 1614: 1607: 1599: 1590: 1589: 1586: 1585: 1574: 1559: 1546: 1541: 1540: 1538: 1537:Classification 1530: 1529:External links 1527: 1525: 1524: 1483: 1428: 1369: 1342:(3): 246–251. 1322: 1267: 1238:(3): 306–309. 1218: 1189:(3): 257–262. 1183:Pain Physician 1169: 1134:Anesthesiology 1120: 1099:(6): 739–747. 1079: 1058:(4): 479–488. 1038: 1017:(1): 310–316. 997: 941: 902:(3): 374–377. 882: 847:(5): 430–437. 827: 778: 729: 680: 631: 604:(5): 502–508. 585: 538: 481: 431: 402:(973): 713–6. 369: 348:(1): 595–602. 316: 314: 311: 300: 299: 296: 293: 280: 277: 211: 208: 188: 185: 180: 177: 175: 172: 158:. A decreased 156:epidural space 147: 144: 130: 127: 91:neck stiffness 66: 65: 62: 56: 55: 44: 43: 35: 34: 31: 27: 26: 18: 15: 9: 6: 4: 3: 2: 1942: 1931: 1928: 1927: 1925: 1910: 1907: 1905: 1902: 1900: 1897: 1896: 1894: 1890: 1884: 1881: 1879: 1876: 1874: 1871: 1869: 1866: 1864: 1861: 1859: 1856: 1854: 1851: 1850: 1848: 1846: 1842: 1832: 1829: 1827: 1824: 1823: 1821: 1819: 1815: 1809: 1806: 1804: 1801: 1800: 1798: 1796: 1792: 1786: 1783: 1782: 1780: 1778: 1774: 1771: 1769: 1765: 1755: 1752: 1750: 1747: 1745: 1742: 1740: 1737: 1735: 1732: 1731: 1729: 1727: 1723: 1717: 1714: 1712: 1709: 1707: 1704: 1703: 1701: 1699: 1695: 1687: 1684: 1683: 1682: 1679: 1678: 1676: 1674: 1670: 1664: 1661: 1657: 1654: 1653: 1652: 1649: 1648: 1646: 1644: 1640: 1637: 1635: 1631: 1627: 1620: 1615: 1613: 1608: 1606: 1601: 1600: 1597: 1584: 1580: 1579: 1575: 1573: 1569: 1568: 1564: 1560: 1557: 1556: 1552: 1548: 1547: 1544: 1539: 1535: 1520: 1516: 1511: 1506: 1503:(7): 818–21. 1502: 1498: 1494: 1487: 1479: 1475: 1471: 1467: 1463: 1459: 1455: 1451: 1447: 1443: 1439: 1432: 1424: 1420: 1415: 1410: 1406: 1402: 1397: 1392: 1388: 1384: 1380: 1373: 1365: 1361: 1357: 1353: 1349: 1345: 1341: 1337: 1333: 1326: 1318: 1314: 1310: 1306: 1302: 1298: 1294: 1290: 1286: 1282: 1278: 1271: 1263: 1259: 1255: 1251: 1246: 1241: 1237: 1233: 1229: 1222: 1214: 1210: 1206: 1202: 1197: 1192: 1188: 1184: 1180: 1173: 1165: 1161: 1157: 1153: 1148: 1143: 1139: 1135: 1131: 1124: 1116: 1112: 1107: 1102: 1098: 1094: 1090: 1083: 1075: 1071: 1066: 1061: 1057: 1053: 1049: 1042: 1034: 1030: 1025: 1020: 1016: 1012: 1008: 1001: 993: 989: 985: 981: 977: 973: 969: 965: 961: 957: 953: 945: 937: 933: 928: 923: 919: 915: 910: 905: 901: 897: 893: 886: 878: 874: 870: 866: 862: 858: 854: 850: 846: 842: 838: 831: 823: 819: 814: 809: 805: 801: 797: 793: 789: 782: 774: 770: 765: 760: 756: 752: 748: 744: 740: 733: 725: 721: 716: 711: 707: 703: 699: 695: 691: 684: 676: 672: 667: 662: 658: 654: 650: 646: 642: 635: 627: 623: 619: 615: 611: 607: 603: 599: 592: 590: 581: 577: 573: 569: 565: 561: 557: 553: 549: 542: 534: 530: 525: 520: 516: 512: 508: 504: 500: 496: 492: 485: 477: 473: 468: 463: 460:(5): 718–29. 459: 455: 451: 444: 442: 440: 438: 436: 427: 423: 418: 413: 409: 405: 401: 397: 393: 386: 384: 382: 380: 378: 376: 374: 365: 361: 356: 351: 347: 343: 339: 332: 330: 328: 326: 324: 322: 317: 310: 307: 305: 297: 294: 291: 290: 289: 287: 276: 274: 270: 267: 263: 259: 255: 249: 247: 243: 239: 234: 232: 227: 225: 221: 217: 207: 205: 204:aminophylline 201: 197: 193: 184: 171: 169: 165: 161: 157: 153: 143: 140: 136: 126: 122: 119: 116:. Leakage of 115: 111: 106: 104: 100: 96: 92: 88: 84: 80: 76: 72: 63: 61: 57: 53: 50: 45: 41: 36: 32: 28: 23: 1807: 1576: 1561: 1549: 1500: 1496: 1486: 1448:(1): 78–80. 1445: 1441: 1431: 1386: 1382: 1372: 1339: 1335: 1325: 1287:(1): 56–59. 1284: 1280: 1270: 1235: 1231: 1221: 1186: 1182: 1172: 1140:(2): 334–9. 1137: 1133: 1123: 1096: 1092: 1082: 1055: 1051: 1041: 1014: 1010: 1000: 959: 955: 944: 899: 895: 885: 844: 840: 830: 795: 791: 781: 746: 742: 732: 697: 693: 683: 648: 644: 634: 601: 597: 555: 551: 541: 498: 494: 484: 457: 453: 399: 395: 345: 341: 308: 301: 282: 279:Epidemiology 250: 235: 228: 213: 194: 190: 182: 149: 132: 123: 107: 103:paraesthesia 74: 70: 69: 51: 1904:Orthostatic 552:Anaesthesia 269:paraparesis 200:cosyntropin 87:spinal cord 30:Other names 1899:Eye strain 1785:Migralepsy 313:References 246:blood clot 187:Prevention 79:dura mater 52:(pictured) 1930:Headaches 1768:Secondary 1462:1532-8651 1405:1178-7090 1389:: 39–45. 1356:0959-289X 1301:1070-3004 1254:1496-8975 1205:2150-1149 1074:1110-0400 1033:1110-1849 976:0003-2999 918:1658-354X 861:1532-8651 572:1365-2044 515:1469-493X 210:Treatment 174:Diagnosis 154:into the 60:Specialty 1924:Category 1909:Vascular 1826:Hangover 1651:Migraine 1626:Headache 1519:22511093 1478:21920366 1470:24310044 1423:21386953 1364:15935637 1309:15278703 1213:20495590 1156:11506102 1115:32303377 992:52142441 984:30169405 936:25191190 877:39028435 869:19749586 822:26176166 773:26950232 724:23450533 675:28388808 618:29659437 580:33332606 533:28388808 476:14570796 426:17099089 364:24009943 231:triptans 224:caffeine 220:bed rest 196:Morphine 168:meninges 135:headache 95:tinnitus 1845:ICHD 13 1706:Cluster 1681:Tension 1634:Primary 1583:D051299 1414:3048582 1262:8829870 927:4141388 813:6457875 764:6682345 715:8406520 666:6478120 626:4956569 524:6478120 417:2660496 355:3762227 302:On the 266:spastic 162:in the 99:vertigo 1818:ICHD 8 1795:ICHD 7 1777:ICHD 5 1726:ICHD 4 1698:ICHD 3 1673:ICHD 2 1643:ICHD 1 1517:  1476:  1468:  1460:  1421:  1411:  1403:  1362:  1354:  1317:436062 1315:  1307:  1299:  1260:  1252:  1211:  1203:  1164:569494 1162:  1154:  1113:  1072:  1031:  990:  982:  974:  934:  924:  916:  875:  867:  859:  820:  810:  771:  761:  722:  712:  673:  663:  624:  616:  578:  570:  531:  521:  513:  474:  424:  414:  362:  352:  202:, and 139:nausea 1892:Other 1716:SUNCT 1572:349.0 1474:S2CID 1313:S2CID 1160:S2CID 988:S2CID 873:S2CID 622:S2CID 242:blood 83:brain 1578:MeSH 1567:9-CM 1515:PMID 1466:PMID 1458:ISSN 1419:PMID 1401:ISSN 1360:PMID 1352:ISSN 1305:PMID 1297:ISSN 1258:PMID 1250:ISSN 1209:PMID 1201:ISSN 1152:PMID 1111:PMID 1070:ISSN 1029:ISSN 980:PMID 972:ISSN 932:PMID 914:ISSN 865:PMID 857:ISSN 818:PMID 769:PMID 720:PMID 698:2016 671:PMID 614:PMID 576:PMID 568:ISSN 529:PMID 511:ISSN 499:2017 472:PMID 422:PMID 360:PMID 271:and 218:and 112:and 85:and 75:PDPH 1563:ICD 1551:ICD 1505:doi 1501:132 1450:doi 1409:PMC 1391:doi 1344:doi 1289:doi 1240:doi 1191:doi 1142:doi 1101:doi 1097:124 1060:doi 1019:doi 964:doi 960:127 922:PMC 904:doi 849:doi 808:PMC 800:doi 759:PMC 751:doi 710:PMC 702:doi 661:PMC 653:doi 606:doi 560:doi 519:PMC 503:doi 462:doi 412:PMC 404:doi 350:PMC 1926:: 1581:: 1570:: 1555:10 1513:. 1499:. 1495:. 1472:. 1464:. 1456:. 1446:39 1444:. 1440:. 1417:. 1407:. 1399:. 1385:. 1381:. 1358:. 1350:. 1340:14 1338:. 1334:. 1311:. 1303:. 1295:. 1285:11 1283:. 1279:. 1256:. 1248:. 1236:43 1234:. 1230:. 1207:. 1199:. 1187:13 1185:. 1181:. 1158:. 1150:. 1138:95 1136:. 1132:. 1109:. 1095:. 1091:. 1068:. 1056:48 1054:. 1050:. 1027:. 1015:37 1013:. 1009:. 986:. 978:. 970:. 958:. 954:. 930:. 920:. 912:. 898:. 894:. 871:. 863:. 855:. 845:34 843:. 839:. 816:. 806:. 794:. 790:. 767:. 757:. 745:. 741:. 718:. 708:. 696:. 692:. 669:. 659:. 647:. 643:. 620:. 612:. 602:43 600:. 588:^ 574:. 566:. 556:76 554:. 550:. 527:. 517:. 509:. 497:. 493:. 470:. 458:91 456:. 452:. 434:^ 420:. 410:. 400:82 398:. 394:. 372:^ 358:. 344:. 340:. 320:^ 275:. 264:, 260:, 198:, 97:, 1618:e 1611:t 1604:v 1565:- 1553:- 1543:D 1521:. 1507:: 1480:. 1452:: 1425:. 1393:: 1387:4 1366:. 1346:: 1319:. 1291:: 1264:. 1242:: 1215:. 1193:: 1166:. 1144:: 1117:. 1103:: 1076:. 1062:: 1035:. 1021:: 994:. 966:: 938:. 906:: 900:8 879:. 851:: 824:. 802:: 796:7 775:. 753:: 747:3 726:. 704:: 677:. 655:: 649:4 628:. 608:: 582:. 562:: 535:. 505:: 478:. 464:: 428:. 406:: 366:. 346:4 73:( 54:.

Index


spinal anaesthesia
Specialty
dura mater
brain
spinal cord
neck stiffness
tinnitus
vertigo
paraesthesia
lumbar puncture
spinal anesthesia
cerebrospinal fluid
headache
nausea
cerebrospinal fluid
epidural space
hydrostatic pressure
subarachnoid space
meninges
Morphine
cosyntropin
aminophylline
pain medications
bed rest
caffeine
triptans
epidural blood patch
blood
blood clot

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