Update on risk factors for post-dural puncture headache

INTRODUCTION: Post-dural puncture headache is the most common complication of dural puncture, reporting an incidence ranging between 10% and 40%. The father of epidural anesthesia, August Bier, reported the first case of post-dural puncture headache in 1899, attributing it to cerebrospinal fluid loss. There are two theories to explain its origin; the first is the theory of the crack and the second is the theory of Monro-Kellie-Burrows. Knowledge of risk factors allows to predict the likelihood of developing this disease. OBJECTIVE: To review the current evidence pertaining to the risk factors involved in its development. RESEARCH METHODOLOGY: Conducted literature research in PubMed, ProQuest, and Virtual Library of Health in the period between the 14th and 30th of November of 2014. CONCLUSIONS: Age, female gender, personal history of post-dural puncture headache, traumatic needle and orientation of perpendicular bevel are all risk factors with statistical significance. While results from other studies were inconclusive for factors such as low weight (BMI<25Kg/m2), personal history of headaches, increased size of needle, no reinsertion of stylet and a high number of attempts to puncture