Post Dural Puncture Headache After Spinal Cord Stimulator Lead Insertion Successfully Treated with Occipital Nerve Blocks.

Abstract

Post-dural puncture headache (PDPH) is a common and debilitating complication that can arise after spinal or epidural anesthesia, or following the placement of spinal cord stimulation leads due to inadvertent dural puncture. We report the case of a 54-year-old female who developed severe PDPH following a spinal cord stimulator trial, complicated by a failed EBP performed by an outside physician. The patient presented to the emergency department with debilitating bilateral occipital headaches exacerbated by an upright position. Given the failure of the EBP, she was treated with bilateral occipital nerve blocks, which resulted in near-complete and rapid resolution of her symptoms. This case highlights the effectiveness of occipital nerve blocks as a therapeutic option for PDPH, especially in challenging cases where other treatments have proven inadequate. Given the positive outcome observed, occipital nerve blocks should be considered a viable treatment option in the management of PDPH, warranting further study to better understand its role in clinical practice.