TY - JOUR
T1 - It.ÇÖs not always postdural puncture headache
T2 - a case report and note to the astute anesthesiologist
AU - Khan, Ejaz
AU - Babazade, Rovnat
AU - Ibrahim, Mohamed
AU - Simon, Michelle
AU - Juarez, Lindsay
AU - Roni, Mandonca
AU - Rakesh, Vadhera
N1 - Publisher Copyright:
© 2021 Sociedade Brasileira de Anestesiologia
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Dural puncture is either diagnosed by unexpectedly profound response to medication test dose or development of a postpartum postural headache. Epidural blood patch is the gold standard for treatment of PDPH when conservative management fails. However, postpartum headaches can be resistant to multiple epidural blood patches. In such cases, preexisting intracranial processes should be considered and ruled out. We report here the unique case of a pregnant patient who developed a resistant headache in the postpartum period related to an incidental intracranial aneurysm. Subsequent treatment with endovascular embolization adequately relieved her symptoms. Early surgical consultation and a multidisciplinary team approach involving neurology and neuroimaging is required for successful management of patients such as the one described here.
AB - Dural puncture is either diagnosed by unexpectedly profound response to medication test dose or development of a postpartum postural headache. Epidural blood patch is the gold standard for treatment of PDPH when conservative management fails. However, postpartum headaches can be resistant to multiple epidural blood patches. In such cases, preexisting intracranial processes should be considered and ruled out. We report here the unique case of a pregnant patient who developed a resistant headache in the postpartum period related to an incidental intracranial aneurysm. Subsequent treatment with endovascular embolization adequately relieved her symptoms. Early surgical consultation and a multidisciplinary team approach involving neurology and neuroimaging is required for successful management of patients such as the one described here.
KW - Endovascular embolization
KW - Epidural blood patch
KW - Incidental intracranial aneurysm
KW - Postdural puncture headache
KW - Unintended dural puncture
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U2 - 10.1016/j.bjane.2021.06.003
DO - 10.1016/j.bjane.2021.06.003
M3 - Article
C2 - 34174280
AN - SCOPUS:85120979024
SN - 0104-0014
VL - 73
SP - 108
EP - 111
JO - Brazilian Journal of Anesthesiology (English Edition)
JF - Brazilian Journal of Anesthesiology (English Edition)
IS - 1
ER -