{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:17Z","timestamp":1787228897978,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Context:<\/jats:title>\n Postdural puncture headache (PDPH) is a common and debilitating complication following spinal anesthesia in obstetric patients, with few objective tools available for early prediction. Optic nerve sheath diameter (ONSD) measured by ultrasonography is a noninvasive surrogate marker of intracranial pressure changes and may aid in early risk stratification.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n To evaluate the prognostic utility of ONSD measurements in predicting PDPH among pregnant women undergoing cesarean section under spinal anesthesia.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This cross-sectional study included 88 pregnant women aged between 18 and 40 years undergoing cesarean section under spinal anesthesia. ONSD was measured using ultrasonography with a 13\u20136 MHz probe at baseline (T0) and at 4 (T4), 24 (T24), 48 (T48), and 72 h (T72) postprocedure. PDPH was diagnosed using International Classification of Headache Disorders criteria.<\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis Used:<\/jats:title>\n \n Data were analyzed using SPSS version 22. Continuous variables were expressed as mean \u00b1 SD and categorical variables as frequencies and percentages. Student\u2019s\n t<\/jats:italic>\n -test and Chi-square\/Fischer\u2019s exact test were used as appropriate. Diagnostic performance was assessed using sensitivity, specificity, predictive values, and ROC curve analysis with calculation of area under the curve (AUC).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n PDPH occurred in 12 patients (13.6%). Baseline ONSD values were comparable between groups. Patients who developed PDPH showed significantly lower ONSD values from T4 onward (\n P<\/jats:italic>\n < 0.05). The best diagnostic performance was at T72 (AUC 0.776; 95% CI 0.663\u20130.889) with a cutoff \u22644.52 mm, yielding 91.7% sensitivity, 69.7% specificity, and 98.1% negative predictive value. ONSD reduction from baseline at T72 was significantly greater in the PDPH group (\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n ONSD measurement at 72 h postspinal anesthesia is a sensitive and clinically useful prognostic tool for predicting PDPH in obstetric patients and may be incorporated into routine postoperative monitoring.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/sja.sja_52_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:20Z","timestamp":1782968420000},"page":"533-537","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Optic nerve sheath diameter as a prognostic tool for postdural puncture headache in pregnant women undergoing caesarean section under spinal anesthesia: A cross-sectional study"],"prefix":"10.4103","volume":"20","author":[{"given":"N.","family":"Amulya","sequence":"first","affiliation":[{"name":"Assistant Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavanya","family":"Kaparti","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh N.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"R1-20260820","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1093\/bja\/aeg231","article-title":"Post-dural puncture headache: 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intracranial pressure after severe brain injury","volume":"33","author":"Geeraerts","year":"2007","journal-title":"Intensive Care Med"},{"key":"R12-20260820","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s12028-009-9250-8","article-title":"Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage","volume":"11","author":"Moretti","year":"2009","journal-title":"Neurocrit Care"},{"key":"R13-20260820","doi-asserted-by":"crossref","first-page":"45","DOI":"10.36076\/ppj.2023.26.45","article-title":"The value of the optic nerve sheath diameter (ONSD) in predicting postdural puncture headache (PDPH): A prospective observational study","volume":"26","author":"Peng","year":"2023","journal-title":"Pain Physician"},{"key":"R14-20260820","first-page":"195","article-title":"The Importance of Optic Nerve Sheath Diameter in Post-dural Puncture Headache Diagnosis and 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