7.2.1 Post-dural puncture headache

Previously used term:
Post-lumbar puncture headache.

Description:
Headache occurring within five days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. It is usually accompanied by neck stiffness and/or subjective hearing symptoms. It remits spontaneously within two weeks, or after sealing of the leak with autologous epidural lumbar patch.

Diagnostic criteria:
A. Any headache fulfilling criterion C
B. Dural puncture has been performed
C. Headache has developed within 5 days of the dural puncture
D. Not better accounted for by another ICHD-3 diagnosis.

Comment:
Independent risk factors for 7.2.1 Post-dural puncture headache have recently been demonstrated: female gender, age between 31 and 50 years, a previous history of 7.2.1 Post-dural puncture headache and orientation of the needle bevel perpendicular to the long axis of the spinal column at the time of the dural puncture.