scholarly journals Case report: Epidural blood patch in the treatment of abducens palsy after a dural puncture

2007 ◽  
Vol 54 (2) ◽  
pp. 146-150 ◽  
Author(s):  
Philippe Béchard ◽  
Gino Perron ◽  
Denis Larochelle ◽  
Mélanie Lacroix ◽  
Annie Labourdette ◽  
...  
Keyword(s):  
Case Report ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Abducens Palsy ◽  
Blood Patch

Treatment of post-dural puncture headache using epidural injection of fibrin sealant as an alternative to autologous epidural blood patch (case report)

2014 ◽  
Vol 5 (3) ◽  
pp. 170-172 ◽  
Author(s):  
Joseph Atallah ◽  
Emmanuel Gage ◽  
Jonathan Koning ◽  
Joan Duggan ◽  
Vicki Ramsey-Williams ◽  
...  
Keyword(s):  
Case Report ◽  
Fibrin Sealant ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Epidural Injection ◽  
Post Dural Puncture Headache ◽  
Patient Morbidity ◽  
Blood Patch ◽  
Immunodeficiency Virus ◽  
Diagnostic Lumbar Puncture

AbstractBackgroundPost dural puncture headache (PDPH) is an iatrogenic cause of patient morbidity in pain management after spinal or epidural anaesthesia, as well as after diagnostic lumbar puncture. Most patients respond to conservative treatment or to epidural blood patch, yet limited options for effective treatment are available for patients who fail these treatments or present with theoretical contraindication.Case reportWe present a case of a patient with previously diagnosed human immunodeficiency virus and hepatitis C, who presented with signs of PDPH, which placed him at a theoretical risk of meningeal seeding of the virus during the blood patching procedure.ConclusionWe successfully treated the post dural puncture headache and avoided the risk of viral seeding of the meninges by using a fibrin sealant.

scholarly journals Repeat epidural blood patch at the level of unintentional dural puncture and its neurologic complications: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Kentaro Iga ◽  
Takeshi Murakoshi ◽  
Airi Kato ◽  
Keiichiro Kato ◽  
Shuhei Terada ◽  
...  
Keyword(s):  
Case Report ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Neurologic Complications ◽  
Blood Patch

scholarly journals Comparisons of clinical characteristics, brain MRI findings, and responses to epidural blood patch between spontaneous intracranial hypotension and post-dural puncture headache: retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gha-Hyun Lee ◽  
Jiyoung Kim ◽  
Hyun-Woo Kim ◽  
Jae Wook Cho
Keyword(s):  
Intracranial Hypotension ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Brain Mri ◽  
Spontaneous Intracranial Hypotension ◽  
Vein Of Galen ◽  
Mri Findings ◽  
Post Dural Puncture Headache ◽  
Straight Sinus ◽  
Blood Patch

Abstract Background Spontaneous intracranial hypotension and post-dural puncture headache are both caused by a loss of cerebrospinal fluid but present with different pathogeneses. We compared these two conditions concerning their clinical characteristics, brain imaging findings, and responses to epidural blood patch treatment. Methods We retrospectively reviewed the records of patients with intracranial hypotension admitted to the Neurology ward of the Pusan National University Hospital between January 1, 2011, and December 31, 2019, and collected information regarding age, sex, disease duration, hospital course, headache intensity, time to the appearance of a headache after sitting, associated phenomena (nausea, vomiting, auditory symptoms, dizziness), number of epidural blood patch treatments, and prognosis. The brain MRI signs of intracranial hypotension were recorded, including three qualitative signs (diffuse pachymeningeal enhancement, venous distention of the lateral sinus, subdural fluid collection), and six quantitative signs (pituitary height, suprasellar cistern, prepontine cistern, mamillopontine distance, the midbrain-pons angle, and the angle between the vein of Galen and the straight sinus). Results A total of 105 patients (61 spontaneous intracranial hypotension patients and 44 post-dural puncture headache patients) who met the inclusion criteria were reviewed. More patients with spontaneous intracranial hypotension required epidural blood patch treatment than those with post-dural puncture headache (70.5% (43/61) vs. 45.5% (20/44); p = 0.01) and the spontaneous intracranial hypotension group included a higher proportion of patients who underwent epidural blood patch treatment more than once (37.7% (23/61) vs. 13.6% (6/44); p = 0.007). Brain MRI showed signs of intracranial hypotension in both groups, although the angle between the vein of Galen and the straight sinus was greater in the post-dural puncture headache group (median [95% Confidence Interval]: 85° [68°-79°] vs. 74° [76°-96°], p = 0.02). Conclusions Patients with spontaneous intracranial hypotension received more epidural blood patch treatments and more often needed multiple epidural blood patch treatments. Although both groups showed similar brain MRI findings, the angle between the vein of Galen and the straight sinus differed significantly between the groups.

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