A patient develops post-dural puncture headache (PDPH) after spinal anaesthesia with a 25-gauge Quincke needle. The headache is characteristically:

• A Occipital, worsens when supine, relieved by sitting up
• B Unilateral throbbing with photophobia independent of posture
• C Constant bifrontal pain unrelated to body position
• D Frontal or occipital, worse in the upright position, relieved by lying flat ✓

Explanation

Post-dural puncture headache results from persistent CSF leak through the dural puncture site, causing intracranial hypotension and compensatory meningeal vessel dilatation. It is characteristically postural — severe in the upright position (sitting or standing) and relieved within 15–30 minutes of lying flat. It is typically bifrontal or occipital and may be accompanied by nausea, neck stiffness, tinnitus, or diplopia. An epidural blood patch (autologous blood 15–20 mL into the epidural space) is the definitive treatment.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.