Postdural puncture headache in obstetric patients复制标题

产科患者硬膜穿刺后头痛

The hypothesized aetiology of the headache is slow cerebrospinal fluid (CSF) leak through the defect in the meninges, causing intracranial hypotension with resultant traction on pain-sensitive structures and reactive venodilatation. The headache is classically bilateral occipitofrontal in location (less commonly in the temporal region or vertex), dull aching or throbbing in character, and of variable severity. A distinctive characteristic of PDPH is its orthostatic nature, with manifestation of symptoms in the upright position and relief on assuming recumbence. The headache may show exacerbation on coughing or straining, and >50% of cases may be associated with additional symptoms such as nausea, photophobia, tinnitus, or vertigo. It is worth noting, however, that atypical presentations that lack a postural component, that have an immediate or delayed onset or a protracted course, or that present as isolated interscapular or back pain with radiation to the upper limbs, have been reported.

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