Department for Neurology, Faculty of Medicine, University of Nis, Nis, Serbia.
Department for Cerebrovascular Diseases and Headache, Clinic for Neurology, Clinical Center of Nis, Blvd. Dr Zorana Djindjica 81, Nis, 18000, Serbia.
Neurol Sci. 2020 Dec;41(12):3563-3568. doi: 10.1007/s10072-020-04757-z. Epub 2020 Sep 30.
This manuscript is a narrative review of peer-reviewed studies of postdural puncture headache (PDPH) as the most common complication of a diagnostic and therapeutic lumbar puncture (LP) and LP due to the damage of the dura mater in epidural anesthesia.
Author searched articles related to the PDPH and its risk factors, pathophysiology diagnosis, differential diagnosis, and therapy. All studies according to the analyzed parameters and their relevance to the clinical practice, as well as quality of the study methods, were selected for further analysis.
The review presents the clinical and paraclinical prediction criteria for the onset, clinical features, course, and efficiency of specific therapeutic interventions which are of a particular clinical benefit for the prevention, pathogenetic treatment, and differential diagnosis of PDPH. The analysis of prediction parameters for the onset, clinical course, and associated symptoms and signs of PDPH is a contribution to the understanding of pathophysiology of intracranial hypotension, since PDPH can be considered a clinical model of intracranial hypotension.
Given that LP is a common procedure in clinical practice, it is necessary to have a comprehensive knowledge of the risk factors, pathophysiological, diagnostic, differentially diagnostic, and therapeutic aspects of PDPH.
本文是对经同行评审的研究进行的叙述性综述，这些研究涉及诊断性和治疗性腰椎穿刺（LP）后头痛（PDPH），这是 LP 后最常见的并发症，也是硬脊膜外麻醉中硬脊膜损伤的结果。
作者检索了与 PDPH 及其危险因素、病理生理学诊断、鉴别诊断和治疗相关的文章。所有研究均根据分析的参数及其与临床实践的相关性，以及研究方法的质量，进行了进一步的分析。
本综述介绍了 PDPH 发生、临床特征、病程和特定治疗干预效果的临床和辅助预测标准，这些标准对 PDPH 的预防、发病机制治疗和鉴别诊断具有特殊的临床意义。对 PDPH 发生、临床病程以及相关症状和体征的预测参数的分析有助于理解颅内低血压的病理生理学，因为 PDPH 可以被认为是颅内低血压的临床模型。
鉴于 LP 在临床实践中是一种常见的操作，因此有必要全面了解 PDPH 的危险因素、病理生理学、诊断、鉴别诊断和治疗方面的知识。
