{
    "abstract": "This narrative literature review examines the long-term impact of postdural puncture headache (PDPH) in postpartum women following an unintended dural puncture (UDP) with a large bore needle commonly used for epidural catheter placement. It seeks to bridge the knowledge gap for the neurologist as to the mounting body of obstetric anesthesia literature on the development of chronic headache after PDPH with this unique needle.\nHeadache is the most common complication of dural puncture, and the risk is greatest in the parturient population. Preexisting risk factors for this population include youth and sex, and after UDP with a large bore needle, almost 70%-80% report a headache. Additionally, there appears to be a significant cohort who experience long-term, persistent headache after UDP.\nWe performed a narrative review of literature using PubMed, searching terms that included long-term follow-up after UDP with a large bore needle in the postpartum population.\nIn women who had UDP with a large bore needle used for epidural catheter placement at delivery, the rate of chronic debilitating headache is around 30% in the months following delivery and may persist for up to a year or longer.\nBased on the existing literature, we have mounting evidence that UDP with the large bore needle used to place an epidural catheter should be understood as a high-risk inciting event for the development of long-term headaches not simply a high risk of acute PDPH. Additionally, consideration should be given to stratifying the etiology of PDPH, based on needle type, and recognizing the entity of chronic PDPH, thus allowing for improvements in research and diagnosis.",
    "authors": [
        {
            "affiliation": "Department of Anesthesiology, Perioperative Medicine and Pain, Stanford University, Stanford, California, USA.",
            "firstname": "Meredith",
            "initials": "M",
            "lastname": "Barad"
        },
        {
            "affiliation": "Department of Anesthesiology, Perioperative Medicine and Pain, Stanford University, Stanford, California, USA.",
            "firstname": "Ian",
            "initials": "I",
            "lastname": "Carroll"
        },
        {
            "affiliation": "CEU San Pablo University School of Medicine, Madrid, Spain.\nDepartment of Anesthesiology, Madrid-Montepr\u00edncipe University Hospital, Madrid, Spain.\nDepartment of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.",
            "firstname": "Miguel A",
            "initials": "MA",
            "lastname": "Reina"
        },
        {
            "affiliation": "Department of Anesthesiology, Perioperative Medicine and Pain, Stanford University, Stanford, California, USA.",
            "firstname": "Jessica",
            "initials": "J",
            "lastname": "Ansari"
        },
        {
            "affiliation": "Department of Anesthesiology, Perioperative Medicine and Pain, Stanford University, Stanford, California, USA.",
            "firstname": "Pamela",
            "initials": "P",
            "lastname": "Flood"
        }
    ],
    "conclusions": "Based on the existing literature, we have mounting evidence that UDP with the large bore needle used to place an epidural catheter should be understood as a high-risk inciting event for the development of long-term headaches not simply a high risk of acute PDPH. Additionally, consideration should be given to stratifying the etiology of PDPH, based on needle type, and recognizing the entity of chronic PDPH, thus allowing for improvements in research and diagnosis.",
    "copyrights": "\u00a9 2021 American Headache Society.",
    "doi": "10.1111/head.14221",
    "journal": "Headache",
    "keywords": [
        "chronic headache",
        "disabling headache",
        "persistent headache",
        "postdural puncture headache",
        "unintended dural puncture"
    ],
    "methods": null,
    "publication_date": "2021-09-28",
    "pubmed_id": "34570902",
    "results": "In women who had UDP with a large bore needle used for epidural catheter placement at delivery, the rate of chronic debilitating headache is around 30% in the months following delivery and may persist for up to a year or longer.",
    "title": "Did she have an epidural? The long-term consequences of postdural puncture headache and the role of unintended dural puncture.",
    "xml": "<Element 'PubmedArticle' at 0x788505b892b0>"
}