Following is not used in the management of Post dural headache -
Ans. is 'a' i.e., Propped up position * Supine (recumbent) position and not propped up is recommended for the management of post dural headache.* Post dural puncture headache is due to CSF leak. Typical location is bifrontalor occipital.* Headache gets worsen on sitting or upright posture and is relieved by lying down position and abdominal pressure - The hallmark of postdural puncture headache i.e., association with body position.* The onset of headache is usually 12-72 hours following the procedure, however, it may be seen almost immediately. In most cases it lasts for 7-10 days.* PDPH is believed to result from leakage of CSF from a dural defect and decreased ICT. Loss of CSF at a rate faster that it can be produced causes traction on structure supporting the brain, particularly dura and tentorium. Traction on cranial nerve (particularly 6th nerve) produces diplopia.* Factors that increase the incidence of PDPH are young age, female sex, Pregnancy, large bore needle and multiple punctures. Timing of ambulation has no effect on incidence of PDPH* Use of small bore needle can prevent PDPH.* Intially conservative treatment is given which includes analgesics (NSAIDs), oral or i.v. fluids, Sumatriptan, cosyntropin, caffeine and recumbent position.* If conservative treatment fails, epidural blood patch can be used. It involves injecting 15-20 ml of autologous blood into the epidural space which stop leakage of CSF by coagulation and mass effect.
Propped up position
Sumatriptan
Hydration
Epidural blood patch
C.N.S.