![]() ![]() 1 Several risk factors for PDPH have been described including larger needle size, cutting needle type, atraumatic tap, and not re-styletting the spinal needle prior to withdrawal. While the headache tends to resolve within days if left untreated, there are reported cases of headaches lasting months. 4 Conservative treatments include hydration, acetaminophen, caffeine, and limiting activity. The reported incidence of post-dural puncture headache (PDPH) is up to 40% and typically occurs within the first few days’ post procedure. Recent lumbar puncture (LP) and suspected spontaneous intracranial hypotension (SIH) are the most frequent indications for EBP at our institution. Headaches due to low CSF pressure are stereotypically orthostatic in character with exacerbation in the upright position and relative improvement while supine. The goal of the epidural blood patch is to treat the symptoms, typically headache, related to cerebrospinal fluid leaks of any cause. 2,3 Currently, an image-guided EBP technique offers a safe and precise approach with the goal of improved efficacy, better patient tolerance, and decreased risk of complication relative to non-image-guided techniques, as well as accurate anatomic localization when a specific target location is required. 1 Since that time, multiple studies have shown efficacy rates ranging from 70-90% in the treatment of post-dural puncture headaches and 52-87% in the treatment of spontaneous intracranial hypotension. The autologous epidural blood patch (EBP) was first shown to be effective in the treatment of these low-pressure headaches in the 1970s. These headaches are typically postural in character, can be severe, and may be associated with nausea, vomiting, neck stiffness, and dizziness. Are there brochures or other printed material that I can take? What websites do you recommend?ĭon't hesitate to ask any other questions.Headaches secondary to leakage of cerebrospinal fluid (CSF), either related to recent dural puncture or spontaneous leakage, have been well described.Are there any restrictions I need to follow?. ![]() What alternatives are there to the approach you're suggesting?.Is my condition likely temporary or chronic?.What is likely causing my symptoms or condition?.For a spinal headache, questions you might ask include: Preparing questions can help you make the most of your time with your provider. Write down questions to ask your provider. ![]() And someone who accompanies you may remember information that you miss or forget. Depending on your condition, you may need help getting to your appointment.
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