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OBSTETRIC ANESTHESIA

Postdural Puncture Headache: An Imaging-Guided Management Protocol

Mostafa Somri, MD^*, Christian B. Teszler, MD^*, Sonia J. Vaida, MD^*, Boris Yanovski, MD^*, Diana Gaitini, MD, Riad Tome, MD^*, Milo Fradis, MD^*, and Luis A. Gaitini, MD^*

*Department of Anesthesia, Bnai Zion Medical Center; and Radiology Department, Rambam Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

Address correspondence and reprint requests to Mostafa Somri, MD, Department of Anesthesia, Bnai Zion Medical Center, PO Box 4940, 31048 Haifa, Israel. Address e-mail to somri_m{at}yahoo.com

IMPLICATIONS: We propose an imaging-based algorithm for the management of headache caused by the inadvertent puncture of dura that occurs sporadically during epidural analgesia. Its implementation can identify those postdural puncture headache cases that cannot benefit from epidural blood patches, and their unnecessary application can consequently be avoided.