Long-Term Outcomes of Post Dural Puncture Headache Treated With Epidural Blood Patch: A Pilot Study

Jamal Hasoon, Ivan Urits, Rana Al-Jumah, Mark Burroughs, Viet Cai, Omar Viswanath, Musa Aner, Paragi H. Rana, Thomas Simopoulos, Alan D. Kaye, Jatinder Gill

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Post dural puncture headache (PDPH) is a known complication which may occur in the setting of patients undergoing lumbar punctures (LP) for diagnostic or therapeutic purposes. The gold standard for treating a PDPH is an epidural blood patch (EBP). There have been few publications evaluating the long-term outcomes of PDPH treated with EBP. The aim of this pilot study was to examine the incidence of chronic headaches in dural puncture patients who received EBP versus those who did not. Methods: A retrospective case control study was performed at a single large center institution. Forty-nine patients who had intentional dural puncture were identified on chart review and completed a survey questionnaire via phone interview: twenty-six of these patients required a subsequent EBP, while twenty-three did not. The primary outcomes were the development and prevalence of chronic headaches after the procedures. There was no statistically significant difference in the prevalence of current headaches between the EBP group and Non-EBP group (54% vs. 52% p = 0.91). There were no significant differences in the rates of severity and descriptive qualities of headache between the EBP and non-EBP groups. There was higher incidence of tinnitus in the PDPH patients. Summary: This pilot study demonstrates that patients who received an EBP for treatment of a PDPH following LP are no more likely to experience chronic headaches compared to patients who do not receive an EBP. However, both the EBP group and Non-EBP group had high incidence of chronic headaches which may be related to dural puncture or a baseline trait of this cohort given the recall bias. There is a suggestion that tinnitus could be a long-term residual symptom of PDPH treated with EBP.

Original languageEnglish (US)
Pages (from-to)25-32
Number of pages8
JournalPsychopharmacology bulletin
Volume50
Issue number4
StatePublished - Oct 15 2020
Externally publishedYes

Keywords

  • chronic headache
  • dural puncture
  • epidural blood patch
  • post dural puncture headache
  • tinnitus

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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