Haller G, et al. - In a nested case-control study, researchers used a root cause analysis framework to determine the risk factors for post-dural puncture headache following trauma to the dural membrane during neuraxial anaesthesia. They matched all patients who had a post-dural puncture headache requiring an epidural blood patch to a random group of control patients without post-dural puncture headache or known dural injury. They also used mixed logistic modelling. In this setting, the individual anaesthetist’s characteristics did not solely account for post-dural puncture headache. The following factors were also found to be related to this event: team composition, the presence of obstetrical perinatal pathology, and associated patient’s conditions. Taking into account all these factors in improvement strategies was recommended.