Epidural blood patch for chronic daily headache with postural component: a case report and the review of published cases.

Abstract

Post dural puncture headache (PDPH) can be observed after any trauma to the dura. The hallmark of PDPH is an increasing headache when assuming the upright position and improvement with the supine position. Diagnosis of PDPH is essentially based on history of dural puncture and clinical presentation. In most cases, if initial conservative therapies fail to provide the relief of symptoms, an epidural blood patch is the therapy of choice. Epidural blood patch is a safe and effective treatment for PDPH and routinely done for acute onset of postural headache after spinal or epidural anesthesia or analgesia. Here, we report the successful treatment of chronic daily headache with a postural component via an epidural blood patch one year after the onset. We also review the literature pertinent to the use of epidural blood patch in chronic daily headache patients with postural component.