Management of persistent post‐dural puncture headache after repeated epidural blood patch

Acta Anaesthesiologica Scandinavica - Tập 51 Số 5 - Trang 633-636 - 2007
Khek Yu Ho1, Tong J. Gan1
11Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Outram Road, Singapore and 2Duke University Medical Center, Durham, North Carolina, USA

Tóm tắt

We report a case of persistent post‐dural puncture headache (PDPH) in a patient despite two epidural blood patches (EBPs). Successful resolution of headache was achieved with a third EBP performed under computed tomography (CT) guidance. A 38‐year‐old female had a total abdominal hysterectomy under combined spinal‐epidural anesthesia with no complications. After surgery, she developed a postural headache consistent with PDPH. The first EBP was performed by injecting autologous blood through the epidural catheter that was in situ. The second EBP was performed under fluoroscopy. The patient continued to have a persistent headache. A computed tomography (CT) myelogram demonstrated cerebrospinal fluid (CSF) leak at L3–4 level. A ‘directed’ CT‐guided blood patch was then performed successfully with resolution of the headache.

Từ khóa


Tài liệu tham khảo

10.1111/j.1365-2044.1989.tb11378.x

10.1097/00000539-199703000-00022

10.1213/00000539-199005000-00017

10.1111/j.1399-6576.1995.tb04136.x

10.1093/bja/aeg231

10.1111/j.1365-2044.1994.tb04258.x

10.1177/0310057X0102900605

10.1054/ijoa.2000.0834

10.1111/j.0001-5172.2004.00345.x

10.1097/00000542-197808000-00024

10.1097/00000542-200108000-00012

10.1093/bja/71.2.182

10.1213/00000539-198910000-00018

10.1016/0952-8180(93)90086-T

10.1007/BF03013783

10.1111/j.1399-6576.1993.tb03793.x

10.1097/01.aco.0000192809.71408.ba

10.1097/00000542-200206000-00035

10.1034/j.1399-6576.2003.00165.x

Perez M, 1993, Facial nerve paralysis after epidural blood patch, Reg Anesth, 18, 196

10.1213/00000539-197554040-00012

10.1177/0310057X8301100102

10.1007/PL00007870

10.1034/j.1399-6576.2001.045005649.x

Rai A, 2005, Epidural blood patch at C2: diagnosis and treatment of spontaneous intracranial hypotension, AJNR Am J Neuroradiol, 26, 2663

10.1213/01.ANE.0000117225.31416.36

10.1097/00115550-200107000-00016

Thông tin
Thông tin xuất bản

Acta Anaesthesiologica Scandinavica

Tập 51 Số 5

633-636

Thông tin tác giả