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7.2.1 Post-dural puncture headache

Previously used term:

Post-lumbar puncture headache.


Headache occurring within 5 days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. It is usually accompanied by neck stiffness and/or subjective hearing symptoms. It remits spontaneously within 2 weeks, or after sealing of the leak with autologous epidural lumbar patch.

Diagnostic criteria:
  1. Headache fulfilling criteria for 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure, and criterion C below
  2. Dural puncture has been performed
  3. Headache has developed within 5 days of the dural puncture
  4. Not better accounted for by another ICHD-3 diagnosis.

Independent risk factors for 7.2.1 Post-dural puncture headache have recently been demonstrated: female gender, age between 31 and 50 years, a previous history of 7.2.1 Post-dural puncture headache and orientation of the needle bevel perpendicular to the long axis of the spinal column at the time of the dural puncture.