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Post dural puncture headache treatment

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https://www.readbyqxmd.com/read/27910226/successful-treatment-of-post-dural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#1
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of post-dural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH. CASE REPORT: This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27591456/bilateral-greater-occipital-nerve-block-for-treatment-of-post-dural-puncture-headache-after-caesarean-operations
#2
Esra Uyar Türkyilmaz, Nuray Camgöz Eryilmaz, Nihan Aydin Güzey, Özlem Moraloğlu
BACKGROUND: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27445257/-bilateral-greater-occipital-nerve-block-for-treatment-of-post-dural-puncture-headache-after-caesarean-operations
#3
Esra Uyar Türkyilmaz, Nuray Camgöz Eryilmaz, Nihan Aydin Güzey, Özlem Moraloğlu
BACKGROUND: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region...
September 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27389119/a-multicenter-clinical-study-on-treating-post-dural-puncture-headache-with-an-intravenous-injection-of-aminophylline
#4
Chuanjie Wu, Yajun Lian, Dongsheng Guan, Lijun Wang, Yanyong Miao, Nanchang Xie, Yuan Chen, Yake Zheng
BACKGROUND: Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture. Aminophylline has been reported to be effective in the prevention of PDPH in some clinical studies, but its efficacy for the treatment of PDPH has been unproven. OBJECTIVE: To evaluate the efficacy and safety of an intravenous (IV) injection of aminophylline on PDPH. STUDY DESIGN: The study was a multicenter, open-label study to assess the effectiveness and safety of aminophylline on PDPH...
July 2016: Pain Physician
https://www.readbyqxmd.com/read/27349779/-accidental-dural-puncture-and-post-dural-puncture-headache-in-the-obstetric-population-eight-years-of-experience
#5
Maria Vaz Antunes, Adriano Moreira, Catarina Sampaio, Aida Faria
INTRODUCTION: Accidental dural puncture is an important complication of regional anesthesia and post-dural puncture headache remains a disable outcome in obstetric population. The aim of our study was to calculate the incidence of accidental puncture and post-puncture headache and evaluate its management among obstetric anesthesiologists. MATERIAL AND METHODS: We conducted a retrospective audit, between January 2007 and December 2014. We reviewed the record sheets of patients who experienced either accidental puncture or post-puncture headache...
April 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27317911/demystifying-post-stroke-pain-from-etiology-to-treatment
#6
Bradly Goodman, Sridhar Vallabhaneni, Bradley Cubitt, Srinivas Mallempati
Unintended dural punctures with cerebral spinal fluid (CSF) leak are recognized as a frequent complication of spinal surgery. Although there are conservative and invasive options to treat post-operative CSF leaks, existing literature defines neither an algorithmic treatment approach nor a universally accepted standard of care. We believe that a transforaminal epidural blood patch (EBP) can serve as a minimally invasive, cost-effective option to treat post-surgical CSF leaks that do not resolve with conservative management...
June 15, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27234863/-the-difficulties-with-the-diagnosis-of-cerebral-sinus-thrombosis-of-a-young-woman-a-case-report
#7
Justyna Kaczmarek, Alicja Kozera-Kępniak, Agata Majos, Beata Kaczorowska
UNLABELLED: Cerebral venous stroke is disfunction of brain cause by thrombosis of cerebral veins or thrombosis of sinus of the dura mater. This disease represents about 0,5-1% of all strokes. Women are ill more often. There are over 100 factors which cause this disease. The most often symptoms are headache, epileptic fit, oedema of optic nerve, loss of visual acuity, speech defects. Magnetic resonance proves the diagnosis. MRI with contrast is recommended. A CASE REPORT: We show the case of a young woman taking the oral contraceptive pill whose only symptom of venous thrombosis for a few days was a strong headache...
May 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27015690/intravenous-cosyntropin-versus-epidural-blood-patch-for-treatment-of-postdural-puncture-headache
#8
Steven R Hanling, Joseph E Lagrew, Derrick H Colmenar, Albin S Quiko, Carol A Drastol
OBJECTIVE: This study evaluated the efficacy of IV cosyntropin as an alternative to epidural blood patch (EBP) for refractory or severe post-dural puncture headache (PDPH). METHODS: Twenty-eight patients were randomized to receive EBP or intravenous cosyntropin after diagnosis with post-dural puncture headache. Efficacy was evaluated immediately after treatment and at 1 day, 3 days, and 7 days following treatment using self-reported verbal reported scores for pain and function related to their headache on a 10-point scale using two-way repeated measures analysis of variance (ANOVA) with multiple comparisons...
March 25, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26939569/spontaneous-intracranial-hypotension-following-epidural-anesthesia-a-case-report
#9
X An, S Wu, F He, C Li, X Fang
We report a case of refractory spontaneous intracranial hypotension (SIH) following epidural anesthesia. In this case, typical clinical symptoms and concomitant use of regional anesthesia led to the misdiagnosis of SIH as post-dural puncture headache (PDPH). A 56-year-old man received a successful appendectomy under epidural anesthesia performed at a T11-T12 intravertebral space. About 20 h later, the patient started complaining about orthostatic headache when getting up from his lying position, then a PDPH was diagnosed...
May 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26530173/-maternal-care-after-vaginal-delivery-and-management-of-complications-in-immediate-post-partum-guidelines-for-clinical-practice
#10
REVIEW
E-G Simon, M Laffon
OBJECTIVE: To provide recommendations on maternal care after vaginal delivery, and management of complications in immediate post-partum period. METHODS: Bibliographic research from the Pubmed database and recommendations issued by the main scientific societies, and assignment of a level of evidence and a recommendation grade. RESULTS: After a vaginal delivery, monitoring of blood pressure, heart rate, bleeding, uterine involution, genital pain, urination, temperature, transit and signs of phlebitis is recommended (professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/26527017/-post-partum-guidelines-for-clinical-practice-short-text
#11
REVIEW
M-V Sénat, L Sentilhes, A Battut, D Benhamou, S Bydlowski, A Chantry, X Deffieux, F Diers, M Doret, C Ducroux-Schouwey, F Fuchs, G Gascoin, C Lebot, L Marcellin, G Plu-Bureau, B Raccah-Tebeka, E Simon, G Bréart, L Marpeau
OBJECTIVE: To determine the post-partum management of women and their newborn whatever the mode of delivery. MATERIAL AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Because breastfeeding is associated with a decrease in neonatal morbidity (lower frequency of cardiovascular diseases, infectious, atopic or infantile obesity) (EL2) and an improvement in the cognitive development of children (EL2), exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (Professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/26402022/safety-concerns-about-an-epidural-blood-patch-in-a-patient-with-extensive-epidural-fluid-accumulation
#12
Wouter Droog, Dick M H Zuidgeest, Leenoud C W de Jonge, Cas J van Oort
We present a case of postdural puncture headache in a patient with extensive epidural fluid accumulation. An initial epidural blood patch was aborted because of concern about increased risk of complications. After magnetic resonance imaging, we proceeded with epidural blood patch with a good therapeutic result. We discuss the imaging results and safety concerns we considered when assessing the benefits and risks of epidural blood patch in this patient.
October 1, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/26275305/successful-neuraxial-analgesia-after-recent-epidural-blood-patch
#13
Trevor A Whitwell, Dongchen Li, Vanny Le, Antonio J Gonzalez-Fiol
Epidural blood patch is a frequently successful treatment for postdural puncture headache. It is not clear whether a recent epidural blood patch affects subsequent neuraxial analgesia. We describe the case of a patient who received an epidural blood patch for postdural puncture headache and returned 3 days later in active labor, requesting epidural analgesia. The patient successfully received analgesia from a combined spinal epidural without further complications. We discuss the anesthetic considerations for providing neuraxial analgesia after a recent epidural blood patch...
August 15, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/26221406/epidural-injection-of-hydroxyethyl-starch-in-the-management-of-post-dural-puncture-headache-a-case-series
#14
Shen Sun, Shao-Qiang Huang
Epidural injection of hydroxyethyl starch may be a suitable alternative for treatment of post-dural puncture headache (PDPH) if epidural blood patch is contraindicated. We reported eight consecutive female patients with accidental dural puncture (ADP), among whom prophylactic or therapeutic epidural injection of hydroxyethyl starch was performed. Prophylactic epidural injection of hydroxyethyl starch 20 ml was conducted once a day for two days, without sufentanil supplementation, and mild PDPH took place in three of four patients...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26123149/bilateral-subdural-hematoma-secondary-to-accidental-dural-puncture
#15
Sofía Ramírez, Elena Gredilla, Blanca Martínez, Fernando Gilsanz
We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time...
July 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/26002663/bilateral-subdural-hygromas-following-administration-of-intrathecal-methotrexate-chemotherapy
#16
Heledd Lewis, Ali Jassem Mahdi, Clare Rowntree
We report the case of a previously well 58-year-old man who presented with headache and confusion 4 days postadministration of intrathecal methotrexate. He was undergoing intensive chemotherapy (CODOX-M/IVAC, cyclophosphamide, doxorubicin, vincristine, methotrexate, etoposide, ifosfamide, cytarabine) for the treatment of leukaemic phase CD20 negative diffuse large B-cell lymphoma. A CT of the head demonstrated the presence of bilateral subdural hygromas complicated by haemorrhage resulting from coexisting chemotherapy induced thrombocytopenia...
2015: BMJ Case Reports
https://www.readbyqxmd.com/read/25993388/the-relationship-of-body-mass-index-with-the-incidence-of-postdural-puncture-headache-in-parturients
#17
COMPARATIVE STUDY
Feyce Peralta, Nicole Higgins, Elizabeth Lange, Cynthia A Wong, Robert J McCarthy
BACKGROUND: Unintentional dural puncture is a known risk after epidural or combined spinal-epidural procedures, occurring in approximately 1% of labor epidural catheters placed in parturients with normal body habitus but may be as high as 4% in morbidly obese parturients. Anecdotal experience and limited publications suggest that an inverse relationship between body mass index (BMI) and postdural puncture headache (PDPH) may exist. We hypothesized that parturients with increased BMI have a lower incidence of PDPH than those with a lower BMI after unintentional dural puncture...
August 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25982607/-acetazolamide-in-the-resolution-of-cerebrospinal-fluid-cutaneous-fistula-after-peridural-analgesia-case-report
#18
Félix Manuel Juárez-Adame, Yolanda Ruiz-Rubio, Ana Bertha Zavalza-Gómez
BACKGROUND: Cerebrospinal fluid cutaneous fistula following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. CLINICAL CASE: Female aged 50 with a stage IIB cervical carcinoma; a peridural catheter was passed at lumbar level; three days after surgery, refers severe headache and to corroborate leakage cerebrospinal fluid through the puncture. The prescription was antibiotics and acetazolamide 250mg every 8hours for five days with favorable evolution...
January 2015: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/25935854/-bilateral-subdural-hematoma-secondary-to-accidental-dural-puncture
#19
Sofía Ramírez, Elena Gredilla, Blanca Martínez, Fernando Gilsanz
We report the case of a 25-year-old woman, who received epidural analgesia for labour pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time...
July 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/25907209/neurotoxicity-of-intrathecal-6-hydroxyethyl-starch-130-0-4-injection-in-a-rat-model
#20
O Vassal, P Del Carmine, P-A Beuriat, F-P Desgranges, N Gadot, B Allaouchiche, Q Timour-Chah, A Stewart, D Chassard
Epidural blood patch is the gold standard treatment for post-dural puncture headache, although hydroxyethyl starch may be a useful alternative to blood if the latter is contraindicated. The aim of this experimental study was to assess whether hydroxyethyl starch given via an indwelling intrathecal catheter resulted in clinical or histopathological changes suggestive of neurotoxicity. The study was conducted in rats that were randomly allocated to receive three 10-μl injections on consecutive days of either saline or hydroxyethyl starch administered via the intrathecal catheter...
September 2015: Anaesthesia
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