scholarly journals Peripartum Isolated Cortical Vein Thrombosis in a Mother with Postdural Puncture Headache Treated with an Epidural Blood Patch

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Etienne Laverse ◽  
Sarah Cader ◽  
Rajith de Silva ◽  
Sanjiv Chawda ◽  
Satish Kapoor ◽  
...  
Keyword(s):  
Epidural Blood Patch ◽  
Csf Leak ◽  
Postdural Puncture Headache ◽  
Mri Scan ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Blood Patch ◽  
Low Pressure Headache ◽  
Pressure Headache

A 32-year-old woman presented with low pressure headache 3 days after delivery of her baby. An assessment of postdural puncture headache was made. This was initially treated with analgesia, caffeine, and fluids for the presumed cerebrospinal fluid (CSF) leak. The woman was readmitted two days after her hospital discharge with generalised seizures. A brain scan showed features of intracranial hypotension, and she was treated for CSF leak using an epidural blood patch. Her symptoms worsened and three days later, she developed a left homonymous quadrantanopia. An MRI scan confirmed a right parietal haematoma with evidence of isolated cortical vein thrombosis (ICVT).

Multiple Fibrin Glue Use in a Complicated Case of Postdural Puncture Headache Following Intrathecal Drug Delivery System Placement: A Case Report

2019 ◽  
pp. 77-81
Author(s):  
Matthew Chung
Keyword(s):  
Drug Delivery ◽  
Cerebrospinal Fluid ◽  
Drug Delivery System ◽  
Fibrin Glue ◽  
Delivery System ◽  
Epidural Blood Patch ◽  
Csf Leak ◽  
Postdural Puncture Headache ◽  
Intrathecal Drug Delivery ◽  
Blood Patch

A postdural puncture headache (PDPH) is a well-described complication after implantation of an intrathecal drug delivery system (IDDS). Treatment is typically with supportive management with the occasional need for an epidural blood patch. We describe a case of a patient with refractory muscle spasticity secondary to cerebral palsy that required a baclofen IDDS implantation and subsequently developed a PDPH. After failing conservative therapy as well as an epidural blood patch, the decision was made to attempt an epidural fibrin patch, which transiently improved her headache. Upon return of the patient’s symptoms, computed tomography myelogram demonstrated an extensive cerebrospinal fluid leak with ventral spread into the retroperitoneal space. Using a novel technique, a second epidural fibrin glue patch was administered just adjacent to the IDDS catheter insertion point, which was then successful in resolving her symptoms. Key words: Intrathecal drug delivery system, postdural puncture headache, dural tear, cerebrospinal fluid (CSF) leak, fibrin glue, epidural blood patch

Epidural Blood Patch

2018 ◽  
Author(s):  
Kenneth D. Candido ◽  
Teresa M. Kusper ◽  
Bora Dinc ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Drug Delivery Systems ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Post Dural Puncture Headache ◽  
Blood Patch ◽  
Csf Leakage ◽  
Pressure Dynamics ◽  
Diagnostic Lumbar Puncture ◽  
Low Pressure Headache ◽  
Pressure Headache

Post-dural-puncture headache (PDPH) is a consequence of neuraxial anesthesia, diagnostic lumbar puncture, intrathecal drug delivery systems, or any other technique involving dural trespass. The spinal headache results from a dural puncture that leads to cerebrospinal fluid (CSF) leakage from the subarachnoid space to the epidural space, culminating in intracranial hypotension and development of a low-pressure headache. A key element of PDPH is an increase in pain severity upon a change in position from supine to upright, which corresponds to a gravity-induced influence on CSF pressure dynamics. Age, sex, and design of the needle used correlate with the risk of headache. Sometimes, the headache resolves spontaneously. At other times, conservative treatment or aggressive measures are required to terminate the pain. An autologous epidural blood patch is an established way preventing or treating PDPH. A careful history must be obtained to identify other causes of headache before the blood patch is attempted.

scholarly journals Postdural Puncture Headache

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed Ghaleb
Keyword(s):  
Dural Puncture ◽  
Laboratory Research ◽  
Postdural Puncture Headache ◽  
First Case ◽  
Blood Patch ◽  
Risk Patients ◽  
Small Gauge ◽  
Low Pressure Headache ◽  
Pressure Headache ◽  
Cutting Point

Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24–48 h of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications of AEBP are rare.

Multimodal diagnosis of cortical vein thrombosis

2007 ◽  
Vol 34 (S 2) ◽  
Author(s):  
J Linn ◽  
T Pfefferkorn ◽  
S Michl ◽  
M Wiesmann ◽  
S Hartz ◽  
...  
Keyword(s):  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

scholarly journals Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Yu Chen ◽  
Bin Cui ◽  
Tianyi Xiao
Keyword(s):  
Venous Thrombosis ◽  
Polycythemia Vera ◽  
Delayed Diagnosis ◽  
Janus Kinase ◽  
Cerebellar Hemisphere ◽  
Cerebellar Tumor ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
V617f Mutation

Abstract Background Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon. Case presentation This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation. Conclusion Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.

What is the actions mechanism of lumbar epidural blood patch in the treatment of the headache by spontaneous carvical CSF leak?

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 75
Author(s):  
I. Arpino ◽  
E. Ferrante ◽  
C. Guarnerio ◽  
A. Citterio ◽  
R. Sterzi
Keyword(s):  
Epidural Blood Patch ◽  
Csf Leak ◽  
Blood Patch

CT-guided epidural blood patch for treatment of CSF leak and pseudomeningocele following tethered cord release in a 3-year-old

2016 ◽  
Vol 40 (6) ◽  
pp. 1191-1194 ◽  
Author(s):  
Joshua Cornman-Homonoff ◽  
Andrew Schweitzer ◽  
J. Levi Chazen
Keyword(s):  
Epidural Blood Patch ◽  
Tethered Cord ◽  
Csf Leak ◽  
Ct Guided ◽  
Blood Patch
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