[Post-dural headache throughout four years].

A 36-year-old female received an epidural analgesia during a normal vaginal delivery. Post delivery she developed a frontal/occipital headache, which worsened in the erect position. Initial treatment with a blood-patch was without symptom relief. Her past medical history was significant because of occasional migraine headaches. For the next four years the patient complained of persistent headaches. At a Centre for Headaches she was diagnosed with post dural puncture headache. After treatment with bed rest for 3 days and a second blood-patch she was symptom free. This case highlights the need for an additional blood-patch in specific cases of residual post dural puncture headache.