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Epidural Blood Patch

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https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#1
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#2
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28240618/epidural-blood-patch-in-children-under-anesthesia-is-there-an-indication-for-neuromonitoring
#3
Ali Kandil, Gregory Smith, Mohamed Mahmoud, Todd Abruzzo, Sudhakar Vadivelu, Rajeev Subramanyam
No abstract text is available yet for this article.
February 24, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28235535/the-effect-of-second-stage-pushing-and-body-mass-index-on-postdural-puncture-headache
#4
Amber M Franz, Shawn Y Jia, Henry T Bahnson, Akash Goel, Ashraf S Habib
STUDY OBJECTIVE: To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. DESIGN: Retrospective cohort. SETTING: Obstetric ward and operating rooms at a university-affiliated hospital. PATIENTS: One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217066/subdural-hematoma-occurred-after-spinal-anesthesia-in-a-human-immunodeficiency-virus-infected-patient
#5
Kyung Tae Kim, Ji Yeon Kim, Eun Mi Kim, Jun Hyun Kim
A 25-year-old male patient who was infected with human immunodeficiency virus (HIV) underwent a condyloma excision under spinal anesthesia. The patient complained of suspicious postdural puncture headache. The patient did not respond to conservative management. Subsequently, the subdural hematoma (SDH) was found through magnetic resonance imaging. In response, an epidural blood patch was used to improve the symptoms and inhibit the enlargement of the SDH. The patient was discharged after it was confirmed that a headache had subsided without increasing SDH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28196128/in-vivo-images-of-the-epidural-space-with-two-and-three-dimensional-optical-coherence-tomography-in-a-porcine-model
#6
Wen-Chuan Kuo, Meng-Chun Kao, Mei-Yung Tsou, Chien-Kun Ting
BACKGROUND: No reports exist concerning in vivo optical coherence tomography visualization of the epidural space and the blood patch process in the epidural space. In this study, we produced real-time two-dimensional and reconstructed three-dimensional images of the epidural space by using optical coherence tomography in a porcine model. We also aimed to produce three-dimensional optical coherence tomography images of the dura puncture and blood patch process. METHODS: Two-dimensional and three-dimensional optical coherence tomography images were obtained using a swept source optical coherence tomography (SSOCT) system...
2017: PloS One
https://www.readbyqxmd.com/read/28192271/ventral-spontaneous-durotomy-following-vaginal-delivery
#7
Nitin Agarwal, Ahmed I Kashkoush, Arpan V Prabhu, Raymond F Sekula
INTRODUCTION: Dural breaches have a diverse etiology, including spontaneous rupture and trauma. Most cases resolve with bedrest, though in refractory cases an epidural blood patch can be placed to obstruct further leakage. Here, we discuss a unique case of a spontaneous ventral durotomy following vaginal delivery managed with injections of autologous blood through bilateral transforaminal needles. CLINICAL PRESENTATION: A previously healthy 36-year-old pregnant female presented to the inpatient maternity ward with positional occipital headaches and neck pain 24 hours following normal spontaneous vaginal delivery...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28181949/lumbar-epidural-blood-patch-via-a-caudal-catheter-after-surgical-dural-tear-and-failed-repair-a-case-report
#8
Michael Dorbad, John Han, Shaik Ahmed, Brian Monroe, Michael Entrup
We report a patient who developed a positional headache and pseudomeningocele after multiple lumbar surgeries for low back and radicular pain. An epidural blood patch via a lumbar approach was not feasible as a result of distorted lumbar anatomy after multiple back surgeries. An epidural blood patch was performed via catheter-threaded cephalad from a caudal approach. The patient had immediate relief after the procedure and at 1 year was still symptom-free. This combination technique may be considered as an alternative approach when a percutaneous lumbar epidural blood patch is disadvantageous...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28178090/management-of-a-ventral-cerebrospinal-fluid-leak-with-a-lumbar-transforaminal-epidural-blood-patch-in-a-child-with-persistent-postdural-puncture-headache-a-case-report
#9
Genevieve Dʼsouza, F Glen Seidel, Elliot J Krane
OBJECTIVE: Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. CASE REPORT: An unusual case is described of an 11-year-old boy with PDPH, which was successfully managed with a ventral (anterior) epidural blood patch and epidural saline infusion after headache and other symptoms failed to resolve after conservative treatment and conventionally performed blood patches...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28131118/postdural-puncture-headache-an-evidence-based-approach
#10
REVIEW
Robert R Gaiser
Headache after dural puncture is a common complication accompanying neuraxial anesthesia. The proposed cause is loss of cerebrospinal fluid through the puncture into the epidural space. Although obstetric patients are at risk for the development of this headache because of female gender and young age, there is a difference in the obstetric population. Women who deliver by cesarean delivery have a lower incidence of headache after dural puncture compared with those who deliver vaginally. Treatment of postdural puncture headache is an epidural blood patch...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28110544/intracranial-structural-alteration-predicts-treatment-outcome-in-patients-with-spontaneous-intracranial-hypotension
#11
Hanna Choi, Mi Ji Lee, Hyun Ah Choi, Jihoon Cha, Chin-Sang Chung
Background Intracranial structural dislocation in spontaneous intracranial hypotension (SIH) can be measured by various intracranial angles and distances. We aimed to identify the clinical significance of structural dislocation in relation to treatment outcome in patients with SIH. Methods In this retrospective analysis, we identified patients with SIH who received an epidural blood patch (EBP) at Samsung Medical Center from January 2005 to March 2015. Structural dislocation in pretreatment MRIs of SIH patients was assessed by measuring tonsillar herniation, mamillopontine distance, the angle between the vein of Galen and straight sinus (vG/SS angle), the pontomesencephalic angle, and the lateral ventricular angle...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28100860/-a-pediatric-case-of-intractable-cerebrospinal-fluid-leakage-after-implantation-of-an-intrathecal-baclofen-pump
#12
Akitsugu Morishita, Hideo Aihara, Tomoaki Nakai, Masao Adachi
Intrathecal baclofen(ITB)infusion can offer a useful treatment for severe spasticity;however, numerous complications have been reported. We report a pediatric case in which intractable cerebrospinal fluid(CSF)leakage associated with several inconvenient symptoms arose after implantation of the ITB pump system. A 10-year-old girl with spastic quadriparesis and athetoid cerebral palsy underwent implantation of an ITB delivery system. After discharge, she presented with fluid collection surrounding the pump in the abdomen...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28091819/the-status-of-diagnosis-and-treatment-to-intracranial-hypotension-including-sih
#13
REVIEW
Jin-Ping Lin, Shu-Dong Zhang, Fei-Fang He, Min-Jun Liu, Xiao-Xu Ma
Intracranial hypotension, especially spontaneous intracranial hypotension (SIH), is a well-recognized entity associated with cerebrospinal fluid (CSF) leaks, and has being recognized better in resent years, while still woefully inadequate. An increasing number of factors including iatrogenic factors are realized to involve in development and progression of intracranial hypotension. The diagnosis remains difficult due to the various clinical manifestations, some of which are nonspecific and easily to be neglected...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28079587/review-of-the-alternatives-to-epidural-blood-patch-for-treatment-of-postdural-puncture-headache-in-the-parturient
#14
Daniel Katz, Yaakov Beilin
Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#15
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
April 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28057591/surgical-management-of-spontaneous-spinal-cerebrospinal-fluid-epidural-fistula
#16
Declan G Siedler, Imogen M Ibbett, Nova B Thani
BACKGROUND: Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid (CSF) fistula is a rare condition that can have serious sequelae. Early diagnosis and treatment can be challenging. CASE DESCRIPTION: We present the case of a 17-year-old male who presented with a history of sudden-onset, postural headaches associated with upper thoracic back pain. Magnetic resonance imaging (MRI) demonstrated a thoracic extradural fluid collection and slumping of the brain within the posterior fossa...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28043956/factors-predicting-response-to-the-first-epidural-blood-patch-in-spontaneous-intracranial-hypotension
#17
Jr-Wei Wu, Shu-Shya Hseu, Jong-Ling Fuh, Jiing-Feng Lirng, Yen-Feng Wang, Wei-Ta Chen, Shih-Pin Chen, Shuu-Jiun Wang
Spontaneous intracranial hypotension results from cerebrospinal fluid leakage. Currently, the treatment of choice for spontaneous intracranial hypotension is the epidural blood patch, which has a variable response rate and no clear outcome predictors. This study aimed to identify predictors for response rate of a first targeted epidural blood patch in patients with spontaneous intracranial hypotension. We reviewed cases of patients with spontaneous intracranial hypotension who received targeted epidural blood patch at our hospital between 1 January 2007 and 1 July 2014...
February 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28012862/impact-of-obesity-on-post-dural-puncture-headache
#18
J Song, T Zhang, A Choy, A Penaco, V Joseph
INTRODUCTION: Previous studies have suggested an inverse relationship between obesity and development of dural puncture headache following spinal anesthesia. However, few have investigated the relationship between obesity and headaches after accidental dural puncture with an epidural needle. This study explored whether obesity has any association with headaches following an accidental dural puncture. METHODS: Records of patients who received epidural analgesia for labor and vaginal delivery between January 2011 and June 2015 were reviewed...
October 29, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27922581/pseudomeningocele-aspiration-and-blood-patch-effectively-treats-positional-headache-associated-with-post-operative-lumbosacral-pseudomeningocele
#19
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-postdural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#20
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of postdural 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
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