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Epidural Blood Patch

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https://www.readbyqxmd.com/read/28697030/severe-postpartum-headache-and-hypertension-caused-by-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#1
Ed McIlroy, Rajamani Sethuraman, Reshma Woograsingh, Catherine Nelson-Piercy, Edward Gilbert-Kawai
Reversible cerebrovascular vasoconstriction syndrome is an uncommon condition that presents as severe headache and hypertension. Recent literature suggests a 1% incidence in postpartum headache cases. It can cause subarachnoid hemorrhages, cerebral ischemia, and seizures. It is often misdiagnosed as postdural puncture headache or preeclampsia. In this case, a postpartum woman, who had received epidural anesthesia for labor, presented 5 days postpartum with severe headache that did not resolve with an epidural blood patch...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28691978/occam-s-razor-could-not-cut-it-tale-of-2-headaches-in-a-postpartum-patient-a-case-report
#2
James A Dolak, Constantinos G Hadjipanayis, Linda J Demma
Not all postpartum headaches are caused by dural puncture, and it is possible for postpartum patients to have >1 cause for headache. After neuraxial block with an incidental large-gauge dural puncture, our patient developed a severe, classic postdural puncture headache which initially responded to an epidural blood patch. The patient was readmitted 2 days after discharge complaining of recurrent headache less characteristic of a postdural puncture headache, now being bifrontal/retro-orbital and without clear positional component...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28689621/intrathecal-hematoma-and-arachnoiditis-mimicking-bacterial-meningitis-after-an-epidural-blood-patch
#3
F Roy-Gash, N Engrand, E Lecarpentier, M P Bonnet
We present a case of arachnoiditis and an intrathecal hematoma after an epidural blood patch. A 24-year-old parturient underwent an epidural blood patch three days after an accidental dural puncture during epidural labor analgesia. Four days later, the patient developed severe lower back pain, bilateral leg pain, persistent headache and fever. Bacterial meningitis was initially suspected and antibiotics started. Lumbar magnetic resonance imaging was performed and showed an intrathecal hematoma, with no blood in the epidural space...
June 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28678882/insertion-of-an-intrathecal-catheter-in-parturients-reduces-the-risk-of-post-dural-puncture-headache-a-retrospective-study-and-meta-analysis
#4
Jiali Deng, Lizhong Wang, Yinfa Zhang, Xiangyang Chang, Xingjie Ma
This study aimed to determine whether insertion of an intrathecal catheter following accidental dural puncture (ADP) in obstetric patients can reduce the incidence of post-dural puncture headache (PDPH) and the requirement of a therapeutic epidural blood patch (TEBP). This was also compared with relocating the epidural catheter at a different vertebral interspace. A retrospective study was performed, as well as a meta-analysis of the literature to further validate our findings. We reviewed the records of 86 obstetric patients who suffered from ADP during epidural anesthesia or combined spinal-epidural anesthesia from October 2015 to November 2016 at our institution...
2017: PloS One
https://www.readbyqxmd.com/read/28663641/the-postdural-puncture-headache-and-back-pain-the-comparison-of-26-gauge-atraucan-and-26-gauge-quincke-spinal-needles-in-obstetric-patients
#5
Mehmet Salim Akdemir, Ayhan Kaydu, Yonca Yanlı, Mehtap Özdemir, Erhan Gökçek, Haktan Karaman
BACKGROUND: The postdural puncture headache (PDPH) and postdural puncture backache (PDPB) are well-known complications of spinal anesthesia. There are some attempts to reduce the frequency of complication such as different design of the spinal needles. AIMS: The primary outcome of this study is to compare the incidence of PDPH between 26-gauge Atraucan and 26-gauge Quincke spinal needles in elective cesarean operations. The severity of symptoms, the incidence of backache, technical issues, and comparison of cost of needles are secondary outcomes...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28643170/predictors-and-incidence-of-orthostatic-headache-associated-with-lumbar-drain-placement-following-endoscopic-endonasal-skull-base-surgery
#6
Buqing Liang, Sathwik R Shetty, Sacit Bulent Omay, Joao Paulo Almeida, Shilei Ni, Yu-Ning Chen, Armando S Ruiz-Treviño, Vijay K Anand, Theodore H Schwartz
BACKGROUND: Orthostatic headache (OH) is a potential complication of lumbar drainage (LD) usage. The incidence and risk factors for OH with the use of lumbar drainage during endoscopic endonasal procedures have not been documented. OBJECTIVE: To investigate the incidence of post-procedure OHs associated with placement of LD in patients undergoing endoscopic endonasal procedures. METHODS: We prospectively noted the placement of LDs in a consecutive series of endoscopic endonasal skull base surgeries...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28624560/intracranial-hypotension-following-traumatic-brain-injury-a-diagnostic-and-therapeutic-challenge
#7
Jacob Chen Ming Low, Anan Shtaya, Samantha Hettige
BACKGROUND: Intracranial hypotension (IH) is a recognized cause of coma; however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury. CASE DESCRIPTION: A 67-year-old woman became comatose following evacuation of bilateral acute subdural hematomas with concurrent respiratory failure. Imaging and intraparenchymal intracranial pressure monitoring confirmed secondary IH. She was managed with an epidural blood patch and a 72-hour period in the Trendelenburg position guided by intracranial pressure monitoring and clinical assessment...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28538330/simultaneous-surgical-decompression-of-bilateral-subdural-hematoma-and-an-administration-of-epidural-blood-patch-for-spontaneous-intracranial-hypotension
#8
Ramamani Mariappan, Amitav Philip, Edmond J Gandham, Krishnaprabhu Raju
No abstract text is available yet for this article.
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28504775/efficacy-of-epidural-blood-patches-for-spontaneous-low-pressure-headaches-a-case-series
#9
S Ansel, A Rae, A Tyagi
Patients with a spontaneous cerebrospinal fluid leak, normally at a spinal level, typically present with low-pressure headache. In refractory cases, an epidural blood patch may be attempted. We aimed to assess the efficacy of lumbar epidural blood patching in spontaneous, low-pressure headaches. Methods We retrospectively analysed notes of patients who had an epidural blood patch performed for spontaneous low-pressure headaches in a single centre. Information regarding demographics, radiology and clinic follow-up was extracted from an electronic patient record system...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28466552/greater-occipital-nerve-treatment-in-the-management-of-spontaneous-intracranial-hypotension-headache-a-case-report
#10
G Niraj, Peter Critchley, Mahesh Kodivalasa, Mohammed Dorgham
BACKGROUND: Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. METHODS: A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life...
June 2017: Headache
https://www.readbyqxmd.com/read/28383416/comparison-of-cutting-and-pencil-point-spinal-needle-in-spinal-anesthesia-regarding-postdural-puncture-headache-a-meta-analysis
#11
Hong Xu, Yang Liu, WenYe Song, ShunLi Kan, FeiFei Liu, Di Zhang, GuangZhi Ning, ShiQing Feng
BACKGROUND: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28367283/postdural-puncture-headache
#12
REVIEW
Kyung-Hwa Kwak
Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28364968/-sphenopalatine-ganglion-block-for-postdural-puncture-headache-in-ambulatory-setting
#13
José Miguel Cardoso, Miguel Sá, Rita Graça, Hugo Reis, Liliana Almeida, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Postdural puncture headache (PDPH) is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Supportive therapy is the usual initial approach. Epidural blood patch (EBP) is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB) may be a safer alternative. CASE REPORT: We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before...
March 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28363328/cerebrospinal-fluid-cutaneous-fistula-following-obstetric-epidural-analgaesia-case-report
#14
J J Fedriani de Matos, A V Quintero Salvago, M D Gómez Cortés
Cutaneous fistula of cerebrospinal fluid is a rare complication of neuroaxial blockade. We report the case of a parturient in whom an epidural catheter was placed for labour analgesia and 12h after the catheter was removed, presented an abundant asymptomatic fluid leak from the puncture site, compatible in the cyto-chemical analysis with cerebrospinal fluid. She was treated with acetazolamide, compression of skin orifice of the fluid leakage, antibiotic prophylaxis, hydration and rest, and progressed satisfactorily without requiring blood patch...
March 28, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#15
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28343842/cranial-nerve-palsy-following-central-neuraxial-block-in-obstetrics-a-review-of-the-literature-and-analysis-of-43-case-reports
#16
D J Chambers, K Bhatia
BACKGROUND: Cranial nerve palsy is a rarely reported complication of central neuraxial block in obstetrics. The aetiology is diverse and includes both decreased and increased intracranial pressure. METHODS: Medline, CINAHL, and EMBASE databases were searched to identify cases of cranial nerve palsy following obstetric central neuraxial block. Possible aetiology, clinical symptoms and signs, treatment, and time to resolution were assessed. RESULTS: Forty-one articles containing 43 case reports of cranial nerve palsy following obstetric central neuraxial block were identified...
February 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#17
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#18
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
#19
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension syndrome results from spontaneous spinal cerebrospinal fluid (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...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28240618/epidural-blood-patch-in-children-under-anesthesia-is-there-an-indication-for-neuromonitoring
#20
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
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