Ck VAS score amongst 7 and 9, there was no substantial improvement within the mean VAS score 24 hours right after the block. Conclusions: For sufferers with PDPH in addition to a pre-block VAS score amongst 4 and 6 who do not respond to conservative medical treatment, an ultrasound-guided bilateral occipital nerve block may be helpful. Key WORDS: Higher occipital nerve, Post-dural pain headache, Ultrasound.doi: http://dx.doi.org/10.12669/pjms.311.Tips on how to cite this:Akyol F, Binici O, Kuyrukluyildiz U, Karabakan G. Ultrasound-guided bilateral greater occipital nerve block for the treatment of postdural puncture headache. Pak J Med Sci 2015;31(1):111-115. doi: http://dx.doi.org/10.12669/pjms.311.This really is an Open Access article distributed below the terms of the Inventive DPP-2 Inhibitor MedChemExpress Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, supplied the original function is properly cited. 1. two. 3. 4. 1-4: Fethi Akyol, M.D. Orhan Binici, M.D. Ufuk Kuyrukluyildiz, M.D. Guldane Karabakan, M.D. Erzincan University Faculty of Medicine, Gazi Mengucek Education and Study Hospital, Anesthesiology and Reanimation, Erzincan, Turkey. Correspondence: Orhan Binici, M.D. Erzincan University Faculty of Medicine, Gazi Mengucek Education and Analysis Hospital, Erzincan, Turkey. E-mail: orhan_binici@windowsliveINTRODUCTION Post-dural puncture (PDPH) cIAP-1 Degrader Purity & Documentation headache is really a typical complication for patients with neuroaxial anesthesia.1 The International Headache Society defines PDPH as discomfort that might be bilateral and begins inside 7 days and ends within 14 days, establishing following a lumbar puncture.2 PDPH develops as a consequence of a loss of cerebrospinal fluid (CSF) from the place from the dural rupture towards the epidural area. The sudden decrease in CSF causes the development of an inflammatory reaction in sensitive structures including the dura mater, cerebral arteries and venous sinus, major to PDPH.3 ThePak J Med Sci 2015 Vol. 31 No. 1 pjms.pk Received for Publication: Revision Received: Revision Accepted:May well 28, 2014 October 20, 2014 October 25,Fethi Akyol et al.classical symptoms of PDPH are photophobia, nausea, vomiting, neck stiffness, tinnitus, double vision, dizziness and extreme, throbbing headache. The headache starts at the occipital lobe and spreads to the frontal regions, ultimately reaching the neck and shoulders, and intensifies with standing.four,five The higher occipital nerve penetrates the semispinal iscapitis trapezius muscles to innervate the skin along the posterior portion of the scalp towards the vertex of your skull and also the scalp more than the ear and parotid glands.6,7 It requires sensorial tendons in the C2 and C3 segments in the spinalis. It separates in the dorsal ramus on the C2 segment, requires a fine branch in the C3 segment and innerves the posterior medial from the scalp to the anterior from the vertex. A higher occipital nerve block prevents the sense of pain in this region.eight Within this study we evaluated the PDPH instances that underwent bilateral higher occipital nerve block, who were referred to Erzincan University Faculty of Medicine Gazi Mengucek Education and Research Hospital, and their response for the therapy. Strategies This retrospective study assessed the effect of a bilateral higher occipital nerve block administered in 21 individuals, all American Society of Anesthesiology Danger Classification I or II, who created PDPH just after receiving spinal anesthesia among February 2012 and January 2014 at.