Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord).

Nausea, vomiting, pain in arms and legs, hearing loss, tinnitus, vertigo, dizziness and paraesthesia of the scalp are also common.

[4][1] Smaller needle gauges decrease the odds of PDPH, but make it more challenging to perform the procedure successfully.

A decreased hydrostatic pressure in the subarachnoid space then leads to traction to the meninges with associated symptoms.

[1] However, the evidence that atraumatic needles reduce the risk of post-dural puncture headache (PDPH) without increasing adverse events such as paraesthesia or backache is moderate-quality and further research should be done.

[7] Morphine, cosyntropin, and aminophylline appear effective in reducing post dural puncture headaches.

[18] More rare complications of EBP include misplacement of blood leading to spinal subdural hematoma[19] or intrathecal injection and arachnoiditis,[20] infection with subdural abscess,[21] facial nerve paralysis,[22] spastic paraparesis and cauda equina syndrome.

[1] It is more common in younger patients (especially in the 18–30 age group), women (especially those who are pregnant), and those with a low body mass index (BMI).