[Post-dural-puncture headache and epidural blood patch]

Abstract

Headache is one of the most common complications of dural puncture. Pathophysiology and the predisposing factors involved in this type of headache are reviewed. The treatment is based mainly on two different kinds of procedures: those aimed at increasing cerebrospinal fluid production and those aimed at decreasing its leakage such as epidural blood patch. Although currently blood patch is the most effective treatment modality, it may be associated with unusual and troublesome complications. Both pros and cons are discussed in order to better define its indications and contraindications. The review is based on a computer-assisted search for articles appeared after 1940.