Summary:
Central neuraxial block is an extensively implemented
technique in anaesthetic practice. Spinal dural punctures occur
deliberately in spinal anaesthesia and inadvertently during
attempting epidural blocks. The incidence of disabling
headache following dural perforation ranges from 0.3 to 20%
in spinal anaesthesia and may be upto 70% after accidental
dural puncture in epidural anaesthesia. Decreased CSF volume
causing reduced pressure and responsive cerebral venodilation
due to CSF leakage are deduced as the prime reasons for this
post-dural puncture headache (PDPH). The headache is selflimiting
and 88% of it resolves without any interference, if not