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AAP Grand Rounds 3:48-49 (2000)
© 2000 American Academy of Pediatrics

ANESTHESIOLOGY

Treatment for Post Lumbar Puncture Headaches

Source: Duffy PJ, Crosby ET. The epidural blood patch. Resolving the controversies. Can J Anaesth. 1999;46(9):878–886.

The first 20% of the full text of this article appears below.

This literature review was undertaken in order to gain a better understanding of the practice of placing blood patches (the introduction of autologous blood) into the epidural space to treat headache following lumbar punctures (postdural puncture headache, PDPH). Medline was searched using keywords "epidural blood patch," "prophylactic epidural blood patch," "dural puncture," and "postdural puncture headache." Bibliographies of the retrieved articles were searched for additional relevant articles. Most publications were observational reports, with few comparative studies. The review emphasized original studies of groups of patients managed similarly. The paper has 55 references. PDPH is characterized by pain in the frontotemporal regions, worsened by the upright position and relieved by recumbency. There is often associated nausea when the upright position is assumed (or attempted). If there is no postural component to the headache, the diagnosis . . . [Full Text of this Article]

Thomas J. Mancuso, MD, FAAP
Anesthesiology, Children’s Hospital, Boston, MA