False statement about post-dural puncture headache (PDPH):: (A) Breach of dura, (B) Onset of headache is usually 12-72 hours following procedure, (C) Commonly occipito - frontal in location, (D) Headache is relieved in sitting standing position
Answer is D. Post Dural puncture Headache Pathophysiology - CSF leak - ICP |es - Traction on nerve fibres originating from piamater Site - Occipital > Frontal > Retrorbital Duration - 7-10 days Pathognomic sign - Change in posture aggravates headache Predisposing conditions - Dura cutting needle (spinal needle)* Most commonly seen with 22G Quincke needle Wide bore needle * Multiple attempts * Pregnancy (In pregnancy dura mater is very fragile- venous engorgement fragility increases chances of PDPH is more) Note- Early ambulation never predispose to PDPH