Post Dural Puncture Headache

Spinal anaesthesia developed in the late 1800s. In 1891, Wynter and Quincke aspirated cerebrospinal fluid (CSF) from the subarachnoid space for the treatment of raised intracranial pressure associated with tuberculous meningitis. However it was German surgeon, August Bier, probably first gave spinal anaesthesia and also experienced headache. He first reported this headache being related to excessive loss of cerebrospinal fluid (CSF). Recently there are lots of modification in needle size and its tip which lead to sharp decline in the incidence of post dural puncture headache (PDPH). Various conservative, pharmacological and interventional measures are available. Epidural blood patch has high cure rate. Epidural saline, dextran, opioids, tissue glue are also been used to reduce rate of CSF loss. This review considers all these aspect of PDPH. Journal of Chitwan Medical College 2013; 3(1): 5-10 DOI: http://dx.doi.org/10.3126/jcmc.v3i1.8457