Post-dural puncture headache: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Post-dural puncture headache

Sample item

A 26-year-old woman, 2 days after a caesarean section under spinal anaesthesia with a cutting-tip needle, develops a severe frontal and occipital headache with neck stiffness and tinnitus. The headache is relieved when she lies flat and returns within minutes of sitting up. She is afebrile. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Post-dural puncture headache

Leakage of CSF through the dural hole lowers intracranial pressure, and traction on pain-sensitive structures causes a headache that is worse upright and better supine. Larger and cutting needles carry more risk. Fever points to meningitis, and hypertension or a non-postural pattern would point to other causes.

Option by option

  • A. Cerebral venous sinus thrombosis

    Venous sinus thrombosis gives a persistent, often non-postural headache with seizures or focal signs.

  • B. Bacterial meningitis

    Meningitis presents with fever and a headache that is not relieved by lying flat.

  • C. Post-dural puncture headache (correct)

    Correct. A postural headache after dural puncture, with no fever, is typical of CSF leak.

  • D. Postpartum pre-eclampsia headache

    Pre-eclampsia headache accompanies hypertension and is not relieved by lying flat.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Post-dural puncture headache. Leakage of CSF through the dural hole lowers intracranial pressure, and traction on pain-sensitive structures causes a headache that is worse upright and better supine.

Why is "Cerebral venous sinus thrombosis" not the answer?

Venous sinus thrombosis gives a persistent, often non-postural headache with seizures or focal signs.

Why is "Bacterial meningitis" not the answer?

Meningitis presents with fever and a headache that is not relieved by lying flat.

Why is "Postpartum pre-eclampsia headache" not the answer?

Pre-eclampsia headache accompanies hypertension and is not relieved by lying flat.

What concept does this question test?

It tests Post-dural puncture headache in Anaesthesia. Larger and cutting needles carry more risk. Fever points to meningitis, and hypertension or a non-postural pattern would point to other causes.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Post-dural puncture headache?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.