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Epidural Blood Patch (epidural + blood_patch)

Distribution by Scientific Domains
Medical Sciences100%
Distribution within Medical Sciences
Anesthesia & Pain Management57%
Neurology21%

Selected Abstracts

Cranial Magnetic Resonance Imaging in Spontaneous Intracranial Hypotension after Epidural Blood Patch

PAIN PRACTICE, Issue 3 2008
Baris Bakir MD
,,Abstract: Spontaneous intracranial hypotension (SIH) is a syndrome characterized by orthostatic headache, nausea, vomiting, photophobia, and diplopia. Subdural effusion, diffuse dural enhancement, dilatation of epidural veins, and increased height of hypophysis are cranial magnetic resonance (MR) imaging findings in SIH. Epidural blood patch is reportedly one of the effective treatment options. We present the follow-up MR imaging findings in a case of SIH after a successful epidural blood patch treatment. We propose that cranial MR imaging as an objective test to evaluate the success of epidural blood patch treatment.,, [source]

Headache attributed to spontaneous low CSF pressure: report of three cases responsive to corticosteroids

EUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2004
S. Gentile
The therapy of headache attributed to spontaneous low CSF pressure (previously defined as spontaneous intracranial hypotension) is still a matter of debate. Epidural blood patch is considered the most effective treatment. However, pharmacological strategies may be considered before blood patch. We report three patients with headache attributed to spontaneous low CSF pressure that were successfully treated with oral prednisone. Additional studies may be useful to prove the effectiveness of corticosteroids in this syndrome. [source]

Epidural blood patch for treatment of spontaneous intracranial hypotension

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2002
N. Waguri
Spontaneous intracranial hypotension is an uncommon disease caused by cerebrospinal fluid leakage. We reported a case of a 42-year-old male with postural headache who was diagnosed as having spontaneous intracranial hypotension. His headache did not completely improve by conservative therapies, so he underwent an autologous epidural blood patch. The site of cerebrospinal fluid restoration was identified at the level from the C2 to Th7 epidural space by 111In-DPTA cisternography and computed tomography coupled with myelography, and cervical EBP was performed. Because cerebrospinal fluid drops from the catheter, it is useful to identify the location of the catheter tip under contrast injection X-ray. Rapid and dramatic relief from the headache was obtained, and no serious complications occurred. [source]

Cranial Magnetic Resonance Imaging in Spontaneous Intracranial Hypotension after Epidural Blood Patch

PAIN PRACTICE, Issue 3 2008
Baris Bakir MD
,,Abstract: Spontaneous intracranial hypotension (SIH) is a syndrome characterized by orthostatic headache, nausea, vomiting, photophobia, and diplopia. Subdural effusion, diffuse dural enhancement, dilatation of epidural veins, and increased height of hypophysis are cranial magnetic resonance (MR) imaging findings in SIH. Epidural blood patch is reportedly one of the effective treatment options. We present the follow-up MR imaging findings in a case of SIH after a successful epidural blood patch treatment. We propose that cranial MR imaging as an objective test to evaluate the success of epidural blood patch treatment.,, [source]

Isolated Cortical Venous Thrombosis Associated With Intracranial Hypotension Syndrome

HEADACHE, Issue 6 2009
Sait Albayram MD
The association of intracranial hypotension syndrome with cerebral venous thrombosis is rare. We report our experience with isolated cortical venous thrombosis, which developed after unsuccessful epidural anesthesia. Magnetic resonance imaging showed characteristic imaging findings of intracranial hypotension syndrome, such as dural thickening and brain sagging. We also detected right parietal venous hemorrhagic infarction secondary to right-sided cortical venous thrombosis. After the treatment of intracranial hypotension via epidural blood patch, heparin was used to treat cortical venous thrombosis. [source]

Sumatriptan in Patients With Postdural Puncture Headache

HEADACHE, Issue 4 2000
Neil Roy Connelly MD
Objective.,To determine the efficacy of sumatriptan in the management of patients presenting for an epidural blood patch for the management of postdural puncture headache. Background.,Postdural puncture headache can be quite severe, requiring invasive therapy (ie, epidural blood patch). Sumatriptan has been used successfully in patients with postdural puncture headache, however, its use has not been investigated in a controlled fashion. Methods.,Ten patients with postdural puncture headache presenting for an epidural blood patch were given either saline or sumatriptan subcutaneously. The severity of the headache was evaluated at baseline and 1 hour following injection. If the headache remained severe, an epidural blood patch was performed. Results.,Only one patient in each group received relief from the injection. Conclusions.,We do not recommend sumatriptan in patients who have exhausted conservative management of postdural puncture headache. [source]

Epidural catheter withdrawal , an answer to ineffective epidural blood patch

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2008
A. Ghai
No abstract is available for this article. [source]

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

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2007
K.-Y. Ho
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. [source]

Epidural blood patch for treatment of spontaneous intracranial hypotension

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2002
N. Waguri
Spontaneous intracranial hypotension is an uncommon disease caused by cerebrospinal fluid leakage. We reported a case of a 42-year-old male with postural headache who was diagnosed as having spontaneous intracranial hypotension. His headache did not completely improve by conservative therapies, so he underwent an autologous epidural blood patch. The site of cerebrospinal fluid restoration was identified at the level from the C2 to Th7 epidural space by 111In-DPTA cisternography and computed tomography coupled with myelography, and cervical EBP was performed. Because cerebrospinal fluid drops from the catheter, it is useful to identify the location of the catheter tip under contrast injection X-ray. Rapid and dramatic relief from the headache was obtained, and no serious complications occurred. [source]

Post dural puncture headache in a pediatric patient with idiopathic intracranial hypertension

PEDIATRIC ANESTHESIA, Issue 9 2005
OLUBUKOLA O. NAFIU MD FRCA
Summary We describe the occurrence of postdural puncture headache (PPDH) in an adolescent with idiopathic intracranial hypertension (IIH) and its successful management with an epidural blood patch. PPDH is a very rare occurrence in patients with intracranial hypertension and is described as a paradoxical situation in the literature. There are only two previous case reports (in adults) of the possible association. A 15-year-old obese patient with a diagnosis of IIH had an uneventful diagnostic spinal tap using a 22G Quincke needle in the pediatric emergency department but returned 24 h later with PPDH. After a failed trial of conservative management, she had an uneventful but curative epidural blood patch with 15 ml of autologous venous blood and was able to return to school the day after the blood patch. Follow-up review by her neuro-ophthalmologist shows resolution of her headaches, considerable improvement in her visual field defect and resolution of papilledema. This is the first report of PPDH and its successful management with an epidural blood patch in a pediatric patient with IIH. [source]

The management of a postdural puncture headache in a child

PEDIATRIC ANESTHESIA, Issue 6 2003
Andrew Liley FRCA
Summary We present a case of an 11-year old girl who underwent an elective pyeloplasty and had an epidural catheter placed for per- and postoperative analgesia. Postoperatively she developed a postural headache and severe nausea, and a diagnosis of postdural puncture headache (PDPH) was made. Her symptoms failed to respond to conservative management. An epidural blood patch was performed with immediate and complete resolution of her symptoms. We present this case to highlight the occurrence of PDPH in children and to outline the considerations for management. [source]

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

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2007
K.-Y. Ho
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. [source]

Postdural Puncture Headache in Complex Regional Pain Syndrome: A Retrospective Observational Study

PAIN MEDICINE, Issue 8 2009
Alexander G. Munts MD
ABSTRACT Objective., To describe the unusual course of postdural puncture headache (PDPH) after pump implantation for intrathecal baclofen (ITB) administration in patients with complex regional pain syndrome (CRPS)-related dystonia. Design., Case series based on data collected from 1996 to 2005. Setting., Movement disorders clinic, university hospital. Patients., A total of 54 patients with CRPS-related dystonia who were treated with ITB. Results., A high incidence (76%) and prolonged course (median 18 days, range 2 days to 36 months) of PDPH was found. Radionuclide studies performed in two patients with long-lasting symptoms (12,16 months) did not reveal cerebrospinal fluid (CSF) leakage. In patients without signs of CSF leakage (N = 38), epidural blood patches administered in 24 patients were effective in 54%, while ketamine infusions administered in six patients were effective in 67%. Conclusions., Our observations may suggest that other mechanisms besides intracranial hypotension play a role in the initiation and maintenance of PDPH in CRPS and stimulate new directions of research on this topic. [source]