skip to main content

Post-Dural Puncture Headache – Epidural Blood Patch — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

EasyHeadache & Facial PainPost-Dural Puncture Headache – Epidural Blood PatchSCE Neurology

A 30-year-old man develops a severe positional headache 48 hours after a lumbar puncture. The headache is worst when upright and relieved completely by lying flat. He has bilateral 6th nerve palsies. Conservative measures (bed rest, hydration, caffeine, analgesia) have been tried for 5 days without improvement. What is the next treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Offer an epidural blood patch after anaesthetic assessment and exclusion of contraindications

Persistent post-dural-puncture headache despite conservative measures, particularly with cranial-nerve symptoms, warrants anaesthetic assessment for an epidural blood patch. Acetazolamide reduces CSF production and is not an appropriate treatment for a CSF-leak syndrome.

Reference: Multisociety consensus guideline on post-dural puncture headache: https://pubmed.ncbi.nlm.nih.gov/37582578/