1. Post spinal headache MOHAMED RIFKY

2. Bilateral greater occipital nerve block for treatment of post-dural puncture headache after caesarean operations In conclusion, treatment of PDPH with GON block is seems to be a minimal invasive, easy and effective method especially for patients like new mothers A GON block may be considered before the application of a blood patch. Well- designed controlled studies are needed to assess the role of GON block in the treatment of PDPH.

4. Complication following large-volume epidural blood patches for postdural puncture headache. Lumbar subdural hematoma and arachnoiditis  Abstract:  Significant complications following large-volume epidural blood patches (LEBPs) in two parturients following LEBP for postdural puncture headache are reported. A 39-year-old woman developed a spinal subdural hematoma causing both lumbar back and radicular pain following a single LEBP using 58 mL of blood. The second case was a 33- year-old woman who received three LEBPs over a 4-day period totaling 165 mL of blood. She developed arachnoiditis and chronic sacral radiculopathy with resolution 4 months later.

5. Headache following Spinal Anaesthesia : A Review on Recent Update MR ALAMa, MR RAHEENb, KM IQBALc, MRA CHOWDHURY EPIDURAL BLOOD PATCH IS THE MOST EFFECTIVE FORM OF MANAGING SEVERE HEADACHES. OTHER THERAPIES THAT HAVE BEEN OFFERED HAVE NOT ALWAYS ARISEN THROUGH THE APPLICATION OF LOGIC OR REASONING. IF PDPH PERSISTS UNTREATED, MAY PREDISPOSE TO DEVASTATING COMPLICATIONS SUCH AS SUBDURAL HAEMATOMA, HERNIATION AND EVEN DEATH, THEREFORE PROMPT DIAGNOSIS AND TREATMENT IS MANDATORY. IT IS WISE TO CONSIDER OTHER CAUSES OF THE HEADACHE BEFORE APPLYING ALTERNATIVE AND INVASIVE THERAPEUTIC OPTION

6. Dexamethasone and post-dural puncture headache in women who underwent cesarean delivery under spinal anesthesia: A systemic review and meta-analysis of randomized controlled trials Efrem Fenta a, Simegnew Kibret a, Metages Hunie a, Diriba Teshome  Conclusion: Intravenous dexamethasone failed to decrease the incidence and severity of PDPH in women who underwent cesarean delivery under spinal anesthesia.

7. Unusually early onset of post-dural puncture headache after spinal anaesthesia using a 27G Whittacre needle S. Lomax and A. Qureshi  In view of the clinical symptoms of postural headache, associated with meningism, photophobia, and tinnitus and exclusion of other diagnoses, we have reported the first case of PDPH to occur within 20 min of performing spinal anaesthesia. Lack of published cases regarding a spinal PDPH within the first half-hour using a 27G Whittacre needle reflects the novelty of this case report, or a possible reflection of underreporting.

8. Sphenopalatine Ganglion Blockade for the Management of Postdural Puncture Headache After Lumbar Drain Placement in Patients Undergoing Thoracoabdominal Aortic Aneurysm Repair  The sphenopalatine ganglion can be accessed intranasally with a cotton-tipped applicator directed medially and cephalad to an approximate depth of the posterior middle nasal turbinate. From Waldman SD. Atlas of Interventional Pain Management, fourth ed. Philadelphia: Elsevier; 2015.16 (B) A 12-g 3.00-inch angiocath (BD Angiocath, Becton Dickinson Infusion Therapy Systems, Inc., Sandy, UT) was inserted over a cotton-tipped applicator (Medline Industries, Inc., Northfield, IL) to deliver 1 mL bupivacaine 0.25% via a 10-mL syringe for sustained saturation and absorption into mucosa. Block onset was confirmed by lacrimation and conjunctival injection. (See online supplemental material for video demonstration of a sphenopalatine ganglion block using this apparatus).

9. Reinsertion of the Stylet does not affect Incidence of Post Dural Puncture Headaches (PDPH) after Spinal Anesthesia Nadir S. Sinikoglu 1,*, Hacer Yeter 1, Funda Gumus 1, Enver Belli 1, Aysin Alagol 1, Nesrin Turan 2  Results: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no signifi cant difference between the two groups with respect to the PDPH. Conclusions: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

10. Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture U. Huseyinoglu a, N. Huseyinoglu b, E. Hamurtekin c, ⇑, H. Aygun d, B. Sulu e  In conclusion, we found that pregabalin administration significantly decreased the VAS scores of patients who developed PDPH after spinal anesthesia or diagnostic and/or therapeutic lumbar puncture. Furthermore, the non-steroidal anti-inflammatory drug requirements of the patients were significantly reduced with pregabalin treatment. Pregabalin is a promising pharmacological agent for the management of PDPH.

11. Needles  Spinal needles of different manufacturers with same external diameter. A: Whitacre type. B: Spinal type. C: Sprotte type. D, E: Quincke type. Scanning electron microscopy. Magnification ×40. (Reproduced with permission from Reina MA: Atlas of Functional Anatomy for Regional Anesthesia and Pain Medicine. Heidelberg: Springer; 2015.)

12. Needles  Graphical representations of epidural (needle 4) and spinal needle tip design. Note the large orifice and conical tip of the Sprotte ® Needle 2, compared with the small orifice and diamond tip of the Whitacre Needle 3. Needles 5, 6 and 7 were provided by the Sheffield Anaesthetic Museum and are an indication of the style of spinal needles used in the past. 1, 26G Atraucan ® Double Bevel Design; 2, 26G Sprotte ® Style Pencil Point; 3, 22G Whitacre Style Pencil Point; 4, 16G Tuohy Needle; 5, 17G Barkers Spinal Needle; 6, Large Gauge Spinal Needle; 7, 18G Crawford Needl