Work

Postpunktionskopfschmerz

Year: 2026

Type: article

Abstract: Post-dural puncture headache (PDPH) is a frequent yet often underestimated complication of neuraxial anesthesia. The presumed mechanism involves cerebrospinal fluid loss due to accidental dural perforation, leading to intracranial hypotension and a secondary compensatory vasodilation. Meningeal irritation and neuroinflammatory processes also contribute to the complex pathophysiology. The main symptom is a severe orthostatic headache with pain exacerbation in an upright posture. This can be accompanied by neck stiffness, tinnitus, visual and other neurological disorders. Patient-specific risk factors are young age, female sex and a positive history of headaches and anesthesia-related factors include puncture needle size and design. The epidural blood patch (EBP) is the current gold standard for treatment. The occasionally considerable patient suffering and optimization of the outcomes necessitate a critical analysis of the treatment options.

Source: Die Anaesthesiologie

DOI: 10.1007/s00101-025-01620-8

Authors: Philipp Helmer, Benedikt Siegler, Lena Reese, Patrick Meybohm, Peter Kranke, Vanessa Neef

Institutions: Universitätsklinikum Würzburg, Heidelberg University, Goethe University Frankfurt, University Hospital Frankfurt

Language: German

Topic: Neurosurgical Procedures and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,390