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Epidural Blood Patch

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https://www.readbyqxmd.com/read/27922581/pseudomeningocele-aspiration-and-blood-patch-effectively-treats-positional-headache-associated-with-post-operative-lumbosacral-pseudomeningocele
#1
Stephen Sandwell, Kevin Walter, Per-Lennart Westesson
STUDY DESIGN: Retrospective chart review with limited prospective follow-up survey. OBJECTIVE: To evaluate the efficacy and safety of blood patch injection for the treatment of positional headaches caused by postoperative lumbosacral pseudomeningoceles. SUMMARY OF BACKGROUND DATA: Pseudomeningocele is one of the most common complications after posterior lumbosacral spinal surgery. Common treatments include bedrest, abdominal binder use, subarachnoid lumbar drainage, and surgical re-exploration for durotomy closure...
December 2, 2016: Spine
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
#2
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/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#3
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27861828/postural-headaches-due-to-cerebrospinal-fluid-leakage-through-subarachnoid-pleural-fistula-a-case-report
#4
Sheng-Feng Lin, Hsing-Yu Weng
BACKGROUND: Postural headaches are commonly associated with spontaneous intracranial hypotension and cerebrospinal fluid (CSF) leakage from the spine. A subarachnoid-pleural fistula (SPF) is a very rare and serious type of CSF fistula that has mostly been reported following traumatic causes. CASE REPORT: Here, the case of a 36-year-old woman who suffered from postural headaches after chiropractic manipulation of her neck was reported. Brain and spinal magnetic resonance (MR) imaging showed brain sagging, a C7-T1 dural defect, and overt CSF leakage...
November 10, 2016: Headache
https://www.readbyqxmd.com/read/27861178/use-of-prothrombin-complex-concentrate-for-warfarin-reversal-before-the-performance-of-an-epidural-blood-patch-in-a-patient-with-cortical-vein-thrombosis-and-subdural-hematoma
#5
Kallol Chaudhuri, Cooper W Phillips, Swapna Chaudhuri, John Wasnick
Compared to conventional therapy, several studies with prothrombin complex concentrate (PCC) have recently demonstrated its superior efficacy in rapidly replacing vitamin K-dependent factors for patients with life-threatening hemorrhage. We present a novel use of PCC in a patient with intracranial hypotension, who had received warfarin for treatment of cortical vein thrombosis. However, after anticoagulation, she proceeded to develop bilateral subdural hematomas with descent of cerebellar tonsils. Given the possibility of an occult dural puncture during labor analgesia, an epidural blood patch was performed after administration of PCC and normalization of coagulation parameters, with prompt improvement of the patient's headache...
November 17, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27854087/spontaneous-intracranial-hypotension-complicated-by-malignancyinduced-disseminated-intravascular-coagulation-a-case-report
#6
Hung-Yi Wu, Shu-Shya Hseu, Shih-Pin Chen, Jiing-Feng Lirng, Yen-Feng Wang, Shuu-Jiun Wang, Jong-Ling Fuh
PURPOSE: Spontaneous intracranial hypotension (SIH) is a rare type of headache. The association of SIH with malignancy and disseminated intravascular coagulation (DIC) has not previously been reported. CASE REPORT: A 60-year-old woman had orthostatic headache for more than one month before admission. MRI of brain showed diffuse pachymeningeal enhancement with bilateral subdural hematoma. MR myelography revealed epidural fluid collection and possible CSF leakage at the level of C5 to C6...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27848124/reversible-cerebral-vasoconstriction-syndrome-and-posterior-reversible-encephalopathy-syndrome-associated-with-intracranial-hypotension
#7
Katharina Feil, Robert Forbrig, Franziska S Thaler, Julian Conrad, Suzette Heck, Franziska Dorn, Hans-Walter Pfister, Andreas Straube
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood. METHODS: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Vital signs and initial laboratory testing including urine analysis and drug screening were unremarkable...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27832615/-changes-in-spinal-mri-findings-for-epidural-fluid-collection-in-the-treatment-of-intracranial-hypotension
#8
Norimitsu Nakagawa
We have experienced 30 cases of intracranial hypotension in the last three years. Spinal MRI was performed in all cases, and 27 patients demonstrated epidural fluid collection(EFC). Of these 30 patients, 6 were treated conservatively with bed rest and hydration, and 24 were treated with epidural blood patch(EBP). Twenty-two patients were cured, 4 were improved significantly, and 4 were improved partially. We examined spinal MR images of 22 patients after 3 months of treatment. The EFC wasn't visible in 11 cases;however, residual EFC was found in the 11 remaining cases...
November 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27766904/intraspinal-hypotension-syndrome-presents-as-transient-quadriplegia
#9
Miki Katzir, Svetlana Tov, Ayelet Eran, Gill E Sviri
Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.
October 21, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27695168/epidural-analgesia-complicated-by-dural-ectasia-in-the-marfan-syndrome
#10
Benjamin B Vacula, Chelsea Gray, Michael P Hofkamp, Patrick T Noonan, Russell K McAllister, Kimberly A Pilkinton, Zhiying Diao
Patients with the Marfan syndrome are considered to be high risk during pregnancy and warrant a complete multidisciplinary evaluation. One goal is to minimize hemodynamic fluctuations during labor since hypertensive episodes may result in aortic dissection or rupture. Although they may prevent these complications, neuraxial techniques may be complicated by dural ectasia. The case of a parturient with the Marfan syndrome and mild dural ectasia is presented. During attempted labor epidural placement, unintentional dural puncture occurred...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27693247/value-of-targeted-epidural-blood-patch-and-management-of-subdural-hematoma-in-spontaneous-intracranial-hypotension
#11
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000) typically caused by cerebrospinal fluid (CSF) leakage. Initial treatment involves conservative therapies, but the mainstay of treatment for patients who fail conservative management is the epidural blood patch (EBP). Subdural hematoma (SDH) is a common complication occurring with SIH, but its management remains controversial. In this report, we discuss a 62-year-old female who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
September 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27687382/iterative-epidural-blood-patch-for-recurrent-spontaneous-intracranial-hypotension-during-pregnancy
#12
Joséphine Grange, Gilbert Lorre, Guillaume Ducarme
A 30-year-old woman at 28 weeks presented with sudden onset of intense headache, epigastric pain, hot flushes, nausea, vomiting, and stiff neck. Cerebral magnetic resonance imaging showed pathognonomic signs of spontaneous intracranial hypotension (SIH). Epidural blood patch was performed 2 times during pregnancy for symptoms relief in spite of medical treatments. No other recurrence was noted until the spontaneous delivery. SIH is a rare entity during pregnancy which may be diagnosed using magnetic resonance imaging...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687372/transnasal-sphenopalatine-ganglion-block-for-the-treatment-of-postdural-puncture-headache-in-obstetric-patients
#13
Sheffield Kent, Gregory Mehaffey
STUDY OBJECTIVE: To demonstrate a possible alternative treatment for postdural puncture headache (PDPH). DESIGN: Postdural puncture headache is a common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood patch (EBP) is the standard therapy for PDPH but has risks including pain, dural puncture, and infection. Transnasal sphenopalatine ganglion block (SPGB) has been successfully used to treat migraine, cluster headache, and trigeminal neuralgia...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27642576/levobupivacaine-for-spinal-anesthesia-in-children-cerebrospinal-fluid-aspiration-before-the-injection-does-not-affect-the-spread-or-duration-of-the-sensory-block
#14
Merja Kokki, Marja Heikkinen, Elina Kumpulainen, Aura Vähäoja, Hannu Kokki
BACKGROUND: Several factors are thought to affect the spread and duration of spinal anesthesia (SA) in adults. These include the volume of cerebrospinal fluid (CSF) in the lumbar spinal canal, which has a negative correlation with both the spread and duration of the sensory block. OBJECTIVES: We evaluated whether CSF aspiration before an injection of levobupivacaine affected the spread or duration of SA in children. PATIENTS AND METHODS: SA was induced by levobupivacaine (5 mg/mL, 0...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27641087/nine-year-audit-of-post-dural-puncture-headache-in-a-tertiary-obstetric-hospital-in-singapore
#15
J C Tien, M J Lim, W L Leong, E Lew
BACKGROUND: The KK Women's and Children's Hospital is a tertiary obstetric unit with approximately 11000 deliveries per year. Epidural analgesia is used in about 40% of laboring women. We reviewed the incidence and management of post-dural puncture headache over a nine-year period. METHODS: A retrospective audit of labor epidural analgesia database records from 1 June 2005 to 31 May 2014 was conducted, identifying an "event" as an accidental dural puncture, an inadvertent intrathecal catheter insertion and/or development of a post-dural puncture headache...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27597897/treatment-of-refractory-postdural-puncture-headache-after-intrathecal-drug-delivery-system-implantation-with-epidural-blood-patch-procedures-a-20-year-experience
#16
Markus A Bendel, Susan M Moeschler, Wenchun Qu, Eugerie Hanley, Stephanie A Neuman, Jason S Eldrige, Bryan C Hoelzer
A recent publication reported the incidence of postdural puncture headache (PDPH) in conjunction with intrathecal drug delivery system (IDDS) implantation to be nearly 23 percent. Many patients responded to conservative measures but a percentage needed invasive treatment with an epidural blood patch (EBP). There is limited data to describe the technical details, success rates, and complications associated with EBP in this population. This study aims to provide a retrospective report of EBP for patients suffering from PDPH related to IDDS implantation...
2016: Pain Research and Treatment
https://www.readbyqxmd.com/read/27596235/ct-guided-epidural-blood-patch-for-treatment-of-csf-leak-and-pseudomeningocele-following-tethered-cord-release-in-a-3-year-old
#17
Joshua Cornman-Homonoff, Andrew Schweitzer, J Levi Chazen
An epidural blood patch (EBP) has become standard of care for management of postdural puncture headache, and in recent years, attempts have been made to expand its applicability. Its utility in the management of postsurgical pseudomeningocele remains poorly defined, and few reports describe its use in children. In this case, we report the successful management of lumbar pseudomeningocele via EBP in a 3-year-old after tethered cord release, thereby obviating the need for surgical repair and its potential morbidity...
August 16, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27591456/bilateral-greater-occipital-nerve-block-for-treatment-of-post-dural-puncture-headache-after-caesarean-operations
#18
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/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#19
Mark J Lenart, Jeffrey M Carness
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site...
September 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27558856/cancer-seeding-risk-from-an-epidural-blood-patch-in-patients-with-leukemia-or-lymphoma
#20
Christopher J Demaree, Jose M Soliz, Rodolfo Gebhardt
INTRODUCTION:  Lumber punctures are a common procedure in patients with cancer. However, a potential complication of a lumbar puncture is a postdural puncture headache. The risk of neoplastic seeding to the central nervous system has led to concern over performing epidural blood patches (EBPs) for the treatment of postdural puncture headaches in patients with cancer. The goal of this retrospective study was to evaluate cancer seeding in the central nervous system in patients diagnosed with leukemia or lymphoma...
August 24, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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