This case report describes the successful treatment of chronic headache from intracranial hypotension with bilateral transforaminal (TF) lumbar epidural blood patches (EBPs). The patient is a 65-year-old male with chronic postural headaches. He had not had a headache-free day in more than 13 years. Conservative treatment and several interlaminar epidural blood patches were previously unsuccessful. A transforaminal EBP was performed under fluoroscopic guidance. Resolution of the headache occurred within 5 minutes of the procedure. After three months without a headache the patient had a return of the postural headache. A second transforaminal EBP was performed again with almost immediate resolution. The patient remains headache-free almost six months from the time of first TF blood patch. This is the first published report of the use of transforaminal epidural blood patches for the successful treatment of a headache lasting longer than 3 months.
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http://dx.doi.org/10.1155/2012/923904 | DOI Listing |
J Am Acad Orthop Surg Glob Res Rev
January 2025
Universidad Autónoma de Guadalajara, School of Medicine, Zapopan, Mexico.
Background: Physicians worldwide face the challenging task of improving patient satisfaction by reducing pain in injured patients. Currently, available therapeutic approaches provide only short-term relief of symptoms without addressing long-term satisfaction. This has led to exploring regenerative treatment options that can deliver better outcomes.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Post-dural puncture headache (PDPH) is a debilitating complication of neuraxial anesthesia, particularly prevalent in obstetric patients, usually characterized by a postural headache. PDPH is hypothesized to result from cerebrospinal fluid leakage through a dural puncture, triggering symptoms like neck stiffness and subjective hearing changes. While conservative measures are common for treatment, more refractory cases may require invasive interventions such as an epidural blood patch (EBP).
View Article and Find Full Text PDFCureus
December 2024
Neurosciences, Nassau University Medical Center, East Meadow, USA.
Asynchronous bilateral hematomas are exceedingly rare and pose increased risk and challenge during surgical treatment. In this case report, a 31-year-old male patient was initially found to have only a large left-sided epidural hematoma which was subsequently evacuated. An immediate postoperative CT scan demonstrated a new right-sided epidural hematoma.
View Article and Find Full Text PDFAnaesth Rep
January 2025
Department of Anaesthesia Rabin Medical Centre, Beilinson Hospital Petah Tikva Israel.
Venous thromboembolic disease remains a leading cause of maternal morbidity and mortality. We report a case of a 30-year-old woman at 37 gestation with a history of thalassaemia intermedia and splenectomy. During pregnancy, she had been managed with frequent blood transfusions and enoxaparin.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Department Orthopedics and Traumatology, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia. Electronic address:
Introduction And Importance: Multifocal fractures in a single upper extremity represent a significant clinical challenge, often resulting from high-energy impacts such as motor vehicle accidents or severe falls. These injuries require complex, multifaceted approaches in management, spanning initial acute care to long-term rehabilitation. This paper examines the complexities of diagnosing, treating, and rehabilitating multifocal upper extremity fractures, highlighting the importance of timely intervention and a multidisciplinary approach to maximize functional recovery, minimize long-term disability and the prognosis.
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