• José Francisco Nunes Pereira das Neves, Vinícius La Rocca Vieira, Rodrigo Machado Saldanha, Francisco de Assis Duarte Vieira, Michele Coutinho Neto, Marcos Gonçalves Magalhães, Mariana Moraes Pereira das Neves, and Fernando Paiva Araújo.
• CET, SBA, HU, UFJF, Brazil. jfnpneves@terra.com.br
• Rev Bras Anestesiol. 2005 Jun 1;55(3):343-9.

Background And ObjectivesPost-dural puncture headache is the most frequent complication after spinal anesthesia or accidental dural perforation during attempted epidural block. This report aimed at describing the use of hydrocortisone to treat and prevent post-dural puncture headache (PDPH).Case ReportsThree cases in which hydrocortisone was used to treat and prevent post-dural puncture headache are reported. The first is an obstetric patient submitted to Cesarean section with postoperative headache not responding to conventional medication and epidural blood patch (EBP), however with total remission after intravenous hydrocortisone. The other two patients, who suffered accidental dural perforation during attempted epidural space location, were preventively treated with intravenous hydrocortisone and have not developed headache.ConclusionsIn our cases, hydrocortisone was effective to treat PDPH after failed conservative measures and EBP. Hydrocortisone for accidental dural perforation patients may be useful since it is a noninvasive technique and the incidence of PDPH in this group of patients is high. Controlled studies are needed to determine the actual role of hydrocortisone in preventing and treating PDPH.

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