Which feature is most characteristic of post-dural puncture headache?

Which feature is most characteristic of post-dural puncture headache?

• A. Improves with lying flat
• B. Worsens with sitting or standing
• C. Associated fever
• D. Gradual onset

Answer: (B)

Post-dural puncture headache is caused by a CSF leak after a dural breach, leading to intracranial hypotension. Its most characteristic feature is its postural nature: the headache worsens when you sit up or stand and improves when you lie down. When upright, CSF pressure drops further and the brain may sag slightly, increasing traction on pain-sensitive meninges. It typically begins within hours to a few days after the puncture. Fever or gradual onset are not typical of this condition.

Post-dural puncture headache is caused by a CSF leak after a dural breach, leading to intracranial hypotension. Its most characteristic feature is its postural nature: the headache worsens when you sit up or stand and improves when you lie down. When upright, CSF pressure drops further and the brain may sag slightly, increasing traction on pain-sensitive meninges. It typically begins within hours to a few days after the puncture. Fever or gradual onset are not typical of this condition.