Post dural puncture headache is due to CSF leak which results in decrease CSF pressure (↓ ICT). The onset of headache is usually 12-72 hours after the procedure, However may also present immediately. Predisposing factors includes young age (not elderly), female sex, pregnancy, large bore needle (single most important predisposing factor) and multiple punctures. Use of small bore needle can prevent PDPH. Initially conservative treatment is given. If conservative treatment fails epidural blood patch can be given (not as the first line treatment).