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Surgery Miscellaneous fd2f6f3e

Post spinal headache is due to

A
CSF leaks in the dura
B
Fine needle
C
Toxic effects of the drug
D
Traumatic damage to nerve roots
High-Yield Explanation
A. i.e. (CSF leaks in the dura) (517- Lee's synopsis of anaesthesia 13th)* It is low pressure headache due to seepage of CSF from dural rent (hole) created by spinal needle. The loss may be around 10 ml /hrPost spinal headache - is due to seepage of CSF. Can be minimized by using smaller bore needle (360-KDT 6th)* More common in young pregnant patients and with accidental dural puncture rate during epidural anaesthesia using Touhy needle (60 - 80%). Reduced by the introduction of size 25 G and 27G whitacre pencil point needles. Which replaced cutting needles* Typical location is bifrontal and /or occipital* CSF leakage results in changes in hydrodynamics of brain causing traction on pain sensitive structures like dura, vessels and tentorium producing painTreatment - Caffeine, sumatriptan and adreocorticotropic hormoe, "epidural blood patch"* Related to a reduction in CSF volume due to leakage through the dura (300 - Current. Diagnosis and treatment - pain)

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