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Evidence-based clinical practice guidelines on postdural puncture headache: infographics
  1. Vishal Uppal1,
  2. Robin Russell2,
  3. Hari Kalagara3,
  4. Lisa Leffert4 and
  5. Samer Narouze5,6
  1. 1 Anesthesia, Dalhousie University - Faculty of Health Professions, Halifax, Nova Scotia, Canada
  2. 2 Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  3. 3 Anesthesiology, Mayo Clinic in Florida, Jacksonville, Florida, USA
  4. 4 Anesthesia, Critical Care & Pain Medicine, Yale School of Medicine, New Haven, Connecticut, USA
  5. 5 Northeast Ohio Medical University, Rootstown, Ohio, USA
  6. 6 Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA
  1. Correspondence to Dr Vishal Uppal, Anesthesia, Dalhousie University - Faculty of Health Professions, Halifax, Canada; v.uppal{at}

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Postdural puncture headache (PDPH) may occur after spinal anesthesia, epidural analgesia, or neuraxial procedures. Typically, it presents with headaches, neck stiffness, and hearing symptoms. Additionally, it can be associated with potential complications such as subdural hematoma, cranial nerve dysfunction, or persistent headaches. The two infographics (figures 1 and 2) provide brief highlights of the recently published multisociety guidelines on PDPH.1 2 The report offers a structured, evidence-based approach to understanding and managing PDPH. It also recognizes limitations in the evidence, indicating the need for further research to refine recommendations and improve the management of PDPH. Overall, it serves as a valuable resource for medical professionals dealing with PDPH, offering guidance for diagnosis, prevention, and treatment while acknowledging the gaps in current knowledge.

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Abigail C. Disley and Amy Dodge from IWK Health Center for help with infographic design.



  • X @Ropivacaine, @robin_russell1, @KalagaraHari, @NarouzeMD

  • Contributors All coauthors have contributed to the creation and editing of the infographic and summary paragraph.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests VU and SN are Associate Editors of Regional Anesthesia and Pain Medicine. SN is a Director at Large for the American Society of Regional Anesthesia and Pain Medicine Board of Directors.

  • Provenance and peer review Commissioned; externally peer reviewed.

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