{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:04:03Z","timestamp":1779685443667,"version":"3.53.1"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-dural puncture headache (PDPH) may follow intended or unintended spinal dural puncture and is usually self-limiting. In some patients, however, symptoms persist despite epidural blood patches, while postoperative patient-reported data are largely absent. We assessed headache disability, functional status, and psychosocial burden among respondents self-reporting prior surgery for PDPH or dural-puncture-related CSF leak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online cross-sectional survey was conducted between February and April 2025. Adults who self-reported prior surgical treatment for PDPH or dural-puncture-related CSF leak were recruited through international online patient support groups. Data were analysed descriptively. Key variables included HIT-6 headache disability, symptom trajectory, occupational status, and psychological symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 136 respondents were included; 74.3% were female, with a median age of 38\u202fyears. Diagnostic or therapeutic lumbar puncture was the most frequent reported cause of CSF leak (65.1%), followed by epidural anesthesia (30.6%). Most respondents had undergone a single surgical intervention (73.1%). Complete symptom remission was reported by 9.6% of respondents. Slight and fluctuating improvement was the most frequent trajectory (38.7%; mean HIT-6 61.5, SD 12.0), followed by significant but persistent improvement (27.1%; mean HIT-6 51.5, SD 6.0); 10.4% reported largely unchanged and 5.1% worsened symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among respondents in this self-selected online cohort, persistent headache burden and psychosocial impairment were frequently reported, whereas complete symptom remission was reported by a minority of respondents. Prospective studies with structured follow-up are needed to better characterize postoperative symptom trajectories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1846001","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:46:12Z","timestamp":1779684372000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent headache burden after surgical treatment of post-dural puncture headache: a cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Ali","family":"Kapan","sequence":"first","affiliation":[{"name":"Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Iten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lindenhofspital","place":["Bern, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian T.","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lindenhofspital","place":["Bern, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Donnerstag","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.bpa.2024.11.004","article-title":"Postdural puncture headache: beyond the evidence","volume":"38","author":"Schyns-van den Berg","year":"2024","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1111\/head.14790","article-title":"Diagnostic and therapeutic insights in individuals with persistent post-dural puncture headache: a cross-sectional study","volume":"64","author":"Kapan","year":"2024","journal-title":"Headache"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s10194-024-01765-8","article-title":"Health-related quality of life, work ability and disability among individuals with persistent post-dural puncture headache","volume":"25","author":"Kapan","year":"2024","journal-title":"J Headache Pain"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.bja.2022.08.004","article-title":"Chronic headaches related to post-dural puncture headaches: a scoping review","volume":"129","author":"Zhang","year":"2022","journal-title":"Br J Anaesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"104747","DOI":"10.1016\/j.ijoa.2025.104747","article-title":"Chronic pain and long-term disability following postdural puncture headache in obstetric patients: a five-year prospective follow-up of a case-control cohort","volume":"64","author":"Weiss","year":"2025","journal-title":"Int J Obstet Anesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1111\/anae.15491","article-title":"Persistent headache and low back pain after accidental dural puncture in the obstetric population: a prospective, observational, multicentre cohort study","volume":"76","author":"Niraj","year":"2021","journal-title":"Anaesthesia"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"110787","DOI":"10.1016\/j.jclinane.2022.110787","article-title":"Long-term morbidities following unintentional dural puncture in obstetric patients: a systematic review and meta-analysis","volume":"79","author":"Mims","year":"2022","journal-title":"J Clin Anesth"},{"key":"ref8","first-page":"5749","volume-title":"Refractory Post-dural Puncture Headache: A Case Series on Presenting Symptoms, Imaging Findings, and Treatment (P3-12.004)","author":"Wilhour","year":"2024"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e34","DOI":"10.2196\/jmir.6.3.e34","article-title":"Improving the quality of web surveys: the checklist for reporting results of internet E-surveys (CHERRIES)","volume":"6","author":"Eysenbach","year":"2004","journal-title":"J Med Internet Res"},{"key":"ref11","first-page":"5296","volume-title":"Analysis of the Epidemiologic Profile, Prevalence, and Incidence of Migraine out of 15,490 Spontaneous Intracranial Hypotension Patients from a Multicenter Record Database (TriNetX) (P2-12.008)","author":"Pannu","year":"2024"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.bja.2022.06.040","article-title":"Factors associated with failed epidural blood patch after accidental dural puncture in obstetrics: a prospective, multicentre, international cohort study","volume":"129","author":"Gupta","year":"2022","journal-title":"Br J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1177\/0333102413490348","article-title":"Successful treatment of post-dural-puncture headache with surgical dura repair two years after spinal anesthesia","volume":"33","author":"Pouskoulas","year":"2013","journal-title":"Cephalalgia"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"omae182","DOI":"10.1093\/omcr\/omae182","article-title":"An arachnoid bleb and weeping dura-a persistent low flow CSF-leak after lumbar puncture","volume":"2025","author":"El Rahal","year":"2025","journal-title":"Oxf Med Case Rep"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1136\/rapm-2023-104817","article-title":"Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group","volume":"49","author":"Uppal","year":"2024","journal-title":"Reg Anesth Pain Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1493303","DOI":"10.3389\/fneur.2024.1493303","article-title":"Chronic post-dural puncture headache-a serious and underrated complication following lumbar puncture: a cohort study","volume":"15","author":"Kraus","year":"2024","journal-title":"Front Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e213998","DOI":"10.1212\/wnl.0000000000213998","article-title":"CSF pressure and dynamics in patients with chronic postdural puncture headache: a single-center cohort study","volume":"105","author":"Fung","year":"2025","journal-title":"Neurology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3171\/2016.11.Spine16968","article-title":"Digital subtraction myelography in the investigation of post-dural puncture headache in 27 patients: technical note","volume":"26","author":"Schievink","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3331024231196808","DOI":"10.1177\/03331024231195830","article-title":"Recovery and long-term outcome after neurosurgical closure of spinal CSF leaks in patients with spontaneous intracranial hypotension","volume":"43","author":"Volz","year":"2023","journal-title":"Cephalalgia"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/09638288.2026.2621641","article-title":"Association between psychological factors and headache burden in patients with migraine and tension-type headache: a systematic review and meta-analysis","author":"Tol","year":"2026","journal-title":"Disabil Rehabil"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1846001\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:46:21Z","timestamp":1779684381000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1846001\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":20,"alternative-id":["10.3389\/fneur.2026.1846001"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1846001","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"article-number":"1846001"}}