What is PDPH?
PDPH or Post-Dural Puncture Headache can be a side effect of an epidural which is given to numb the body from the waist down, normally during childbirth. PDPH occurs when the epidural needle is inserted too far into the spine and pierces the dura mater, a layer that surrounds the spinal column, allowing cerebral fluid can to leak out of this tiny hole. The cerebral fluid that the brain floats in will begin to drain from the dura mater puncture, allowing the patient to feel the brain putting pressure on the spinal cord.
What are the symptoms?
Most commonly, people suffering from PDPH will experience a severe headache and pain at the top of the neck or base of the skull. Some people may also feel an associated nausea, possibly due to the pain. The pain will increase if the patient is upright, and therefore the patient normally finds some relief when lying down.
Treatments
In mild cases, the pain can be managed with rest and painkillers, and it is recommended that caffeine can also assist with recovery.
In severe cases, an epidural blood patch (or EBP) may be required. The epidural blood patch is a simple surgical procedure in which blood is taken directly from the patient and injected immediately into the patient's spine, just above the location of the original epidural. The injected blood clots, closing the hole and stopping the leak of further fluids. Once the leak has been stopped, the fluid will the replenish over time. The patient should experience some relief within 24 hours of this procedure, but may experience continued headaches or migraines for several weeks after the procedure. The anaesthetist will however explain that the EBP is not itself without risk, since it is effectively a second epidural procedure.
In severe cases, an epidural blood patch (or EBP) may be required. The epidural blood patch is a simple surgical procedure in which blood is taken directly from the patient and injected immediately into the patient's spine, just above the location of the original epidural. The injected blood clots, closing the hole and stopping the leak of further fluids. Once the leak has been stopped, the fluid will the replenish over time. The patient should experience some relief within 24 hours of this procedure, but may experience continued headaches or migraines for several weeks after the procedure. The anaesthetist will however explain that the EBP is not itself without risk, since it is effectively a second epidural procedure.