A 35 year old male underwent the following procedure before his surgery, After 2 days he developed headache which gets relieved by lying down.What is the definitive treatment for this?
Post-Dural Puncture Headache May follow lumbar puncture, spinal anesthesia, Onset 12-72 hrs and last for 1-2 weeks. Aggravated by sitting and relieved by lying down. Incidence increases with the larger needle, cutting point needle, young age, females, pregnancy. Prevented by use of thinner needle Rx Supine position IV fluids Caffeine and analgesia Epidural blood patch Definitive therapy Performed24-48 hours after dural puncture and the development of classic PDPH symptoms. 15-20 mL of autologous blood is injected into the epidural space at the same or one interspace below the level of the dural puncture. It stops fuher leakage of CSF by either mass effect or coagulation. A second patch performed after 24-48 hours (if needed) Approximately 90% of patients will respond to a single blood patch, and 90% of initial nonresponders will obtain relief from a second injection
NSAIDs and caffeine
Physiotherapy
Autologous blood patch
Caffeine
Central Neuraxial Blockade