Manejo de la cefalea postpunción dural en obstetricia

  1. Clara Sáez Ibarra
  2. Irene Ruiz Adelantado
  3. Lorenzo Alarcón García
  4. Laura Noguera Alonso
Journal:
Revista Sanitaria de Investigación

ISSN: 2660-7085

Year of publication: 2024

Volume: 5

Issue: 5

Type: Article

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Abstract

Postdural puncture headache is the most common complication after performing a neuraxial block. Although its pathophysiology is unclear, it is believed that the loss of cerebrospinal fluid and the associated intracranial vasodilation are responsible for the symptoms. It is a typically fronto-occipital headache that worsens with sitting or standing and improves with lying down. The symptoms begin within the first three days after the dural puncture and subside within two weeks. It may be associated with other neurological symptoms such as neck stiffness or tinnitus. The diagnosis is clinical and imaging tests are indicated only if the evolution is torpid or atypical symptoms are associated. Regarding the risk factors involved, it has been seen that it is much more common in young, low-weight women who have vaginal birth. Technically the needle diameter is the most involved factor. The only treatment that has shown a clear improvement in symptoms is the blood patch, although conservative treatment is usually performed with conventional analgesia, which may include caffeine or hydrocortisone.

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