Postpartum headache, seizures and bloodstained C. S. F.: a possible complication of dural puncture?

1988 ◽  
Vol 14 (2) ◽  
Author(s):  
M.P. Vercauteren ◽  
G.J. Vundelickx ◽  
G.H. Hanegreefs
Keyword(s):  
Dural Puncture ◽  
Postpartum Headache

Extra-axial haemorrhage in a patient with Alport syndrome after epidural anaesthesia

2021 ◽  
Vol 14 (6) ◽  
pp. e242160
Author(s):  
Shanika Wijayanayaka ◽  
Abir Guha ◽  
Kanapathippillai Sivanesan ◽  
Mayooran Veerasingham
Keyword(s):  
Epidural Anaesthesia ◽  
Alport Syndrome ◽  
Dural Puncture ◽  
Cerebrospinal Fluid Leak ◽  
Clonic Seizure ◽  
Subdural Haemorrhage ◽  
Postdural Puncture Headache ◽  
Fluid Leak ◽  
Failure To Progress ◽  
Postpartum Headache

Extra-axial haemorrhage following epidural anaesthesia is extremely rare. We present the case of an 18-year-old G1P0 woman with Alport syndrome who had a ventouse delivery for failure to progress that was complicated by a postpartum tonic–clonic seizure. Clinically, and confirmed radiologically, the patient was found to have experienced an extra-axial haemorrhage (extradural and subdural haemorrhage) secondary to a cerebrospinal fluid leak caused by a dural puncture during epidural anaesthesia. Differentiating between postdural puncture headache, subdural haemorrhage and extradural haemorrhage can be extremely challenging, but it is important to consider these rare conditions when evaluating patients presenting with postpartum headache and seizure.

scholarly journals Post partum headache: a case series

2018 ◽  
Vol 8 (1) ◽  
pp. 317
Author(s):  
Reema Kumar Bhatt ◽  
Rohin Kumar ◽  
L. B. Singh
Keyword(s):  
Dural Puncture ◽  
Sinus Thrombosis ◽  
Post Partum ◽  
Case Series ◽  
Diagnostic Dilemma ◽  
Post Dural Puncture Headache ◽  
Cortical Vein ◽  
First Case ◽  
Cortical Vein Thrombosis ◽  
Postpartum Headache

Postpartum headache is the complaint of head, neck, or shoulder pain occurring during the first 6 weeks following delivery. Among the women who underwent neuraxial aneasthesia Post Dural puncture headache is one of the most common presentations. However, physicians should be aware that post Dural puncture headache is not the only cause of postpartum headache. Authors present a series of four cases that had varied presentation of post partum headache with varied diagnosis, the first case was of subdural haematoma where CT scan revealed an acute on chronic SDH. The second case was diagnosed as meningitis and the CSF for culture sensitivity grew Streptococcus Pneumoniae .In our third case of cortical vein  thrombosis , NCCT followed by MR venogram  revealed left transverse venous sinus thrombosis and our last case in the series was of posterior reversible encephalopathy syndrome where MRI confirmed the findings of typical findings are symmetric edema involving the white matter of the posterior regions of the cerebral hemispheres. The diagnostic dilemma was resolved by neuroimaging because the clinical presentation was not making us reach a satisfactory diagnosis of the cause of headache. Early resort to neuroimaging and multidisciplinary team effort paved way to early diagnosis and appropriate recovery of the patients.

scholarly journals A Case of Postpartum Headache Post Dural Puncture. Post Dural Puncture Headache or Reversible Cerebral Vasoconstriction Syndrome - Posterior Reversible Encephalopathy Syndrome?

2020 ◽  
Author(s):  
Melania Turetti ◽  
Maria Barbagallo ◽  
Umberto Scoditti ◽  
Antonio Genovese ◽  
Laura Angeli ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Dural Puncture ◽  
Postpartum Woman ◽  
Unexpected Event ◽  
Post Dural Puncture Headache ◽  
Posterior Reversible Encephalopathy ◽  
Cerebral Vasoconstriction ◽  
Reversible Encephalopathy ◽  
Prompt Diagnosis ◽  
Postpartum Headache

Abstract BACKGROUNDReversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES) are two rare neurological conditions, clinically characterized of headache. This is sometimes difficult to differentiate from post dural puncture headache (PDPH). In our case a diagnosis of PDPH was made but imaging showed signs of RCVS-PRES. The novelty is that, unlike in cases reported in literature, no liquoral hypotension signs were detected on imaging.CASE PRESENTATIONWe present a case of RCVS-PRES in a postpartum woman that presented headache as first symptom, and only later experienced seizures. Epidural analgesia was performed during labour, and it was complicated by dural puncture that worked as a confounding factor in the clinical postpartum evaluation. Seizures represented an unexpected event in the course of treating this patient for post dural puncture headache.CONCLUSIONSWe point out the attention on changes of clinical characteristics of headache as an important factor to be analyzed, in order to have a prompt diagnosis. Moreover, we evaluate possible triggers of RCVS and PRES; in our case dural puncture is probably not the trigger, in fact there were no liquoral hypotension signs on imaging. According to literature reports, puerperium itself was a promoting factor.

scholarly journals Don’t Forget Rare Causes of Postpartum Headache! Cases Report and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 376
Author(s):  
Marco Di Paolo ◽  
Aniello Maiese ◽  
Ornella Mangiacasale ◽  
Barbara Pesetti ◽  
Simone Pierotti ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Health Professionals ◽  
Postpartum Period ◽  
Dural Puncture ◽  
Careful Examination ◽  
Common Finding ◽  
Post Dural Puncture Headache ◽  
High Level ◽  
Postpartum Headache ◽  
Neuroradiological Imaging

Headache is a common finding in the postpartum period, caused by a spectrum of different conditions. Most headaches in the postpartum period are self-limiting and benign in etiology, but there are some potentially serious causes to be considered. We disclose two cases of postpartum headache, initially considered as post-dural puncture headache (PDPH), that evolved into a harmful condition and showed that an expanded differential diagnosis for headache in the postpartum is mandatory, requiring a high level of attention from health professionals. In fact, a careful examination of the medical history, physical examination, and the recognition for the need for early neuroradiological imaging should incre[se diagnostic accuracy.

Sign in / Sign up

Export Citation Format

Share Document