PDPH is uncommon in the elderly, likely because of brain atrophy. If the headache continues, or if the headache returns, you may be advised to have another blood patch.PDPH is more common in women, younger ages (20 to 40 years), those with prior headaches (especially prior PDPH), and low body mass index. In about 2 in every 3 people who have this kind of headache, the blood patch will cure the headache within 24 hours. What if I still have a headache after treatment? As the fluid leak is stopped, the pressure around the brain will increase and the headache should improve. The blood will clot and so seal the hole that has been made in the dura. Blood is carefully injected into your back by using an epidural needle, placed near to the hole in the dura. Great care is taken to clean your arm and take blood in a fully clean (sterile) manner. The aim is that the blood seals the hole in the dura and stops the leak of fluid. Some of your own blood is injected into your back. Very occasionally, a fit (seizure) can happen.Ī post-dural puncture headache is often treated with an epidural blood patch. If the headache is left untreated, this cushioning is not present and it is occasionally possible for bleeding to occur into or around the brain (a subdural haematoma). The brain is cushioned by the CSF around it. What are my choices if the headache persists?Īlthough the hole in the dura will usually seal over in a number of weeks, it is not usually advisable to wait for this to happen. Young patients and women having the spinal or epidural for childbirth are more likely than other people to have a post-dural puncture headache. Somewhere between 1 in 100 and 1 in 500 people having an epidural or spinal injection will develop a post-dural puncture headache. Therefore, it is very important to treat a post-dural puncture headache. A fit (seizure) can also happen but this is rare. If the headache is left untreated, this cushioning effect is not present and bleeding into or around the brain ( a subdural haematoma) may occasionally occur. On the other hand, lying flat will often improve this type of headache.Īlthough the hole in the dura will usually seal over in a number of weeks, it is not usually a good idea to wait for this to happen. Therefore, sitting or standing often makes the headache worse. If you sit up, the pressure around your brain is reduced even more. This causes a typical headache, which is called a post-dural puncture headache (PDPH). If too much fluid leaks out through the hole in the dura, the pressure in the rest of the fluid around the brain is reduced. But sometimes the hole is big enough to cause some leakage of CSF. The hole made by a spinal needle is very small and no CSF usually leaks out. When a spinal injection is given, a very fine needle is deliberately inserted through the dura.If the needle accidentally punctures the dura, a small hole is made. For an epidural, a needle is used to inject local anaesthetic just outside the membrane that surrounds the spinal cord (this membrane is called the dura).The fluid is called the cerebrospinal fluid (CSF). Your brain and spinal cord are surrounded by fluid.
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