We present a case of postdural puncture headache in a patient with extensive epidural fluid accumulation. An initial epidural blood patch was aborted because of concern about increased risk of complications. After magnetic resonance imaging, we proceeded with epidural blood patch with a good therapeutic result. We discuss the imaging results and safety concerns we considered when assessing the benefits and risks of epidural blood patch in this patient.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1213/XAA.0000000000000192 | DOI Listing |
BMC 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.
View Article and Find Full Text PDFOrthop Surg
January 2025
Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Background: Postoperative spinal epidural hematoma (SEH) is a rare but serious complication following lumbar surgery, with cauda equina syndrome (CES) being one of its most devastating outcomes. While CES typically presents with a combination of bladder and/or bowel dysfunction, diminished sensation in the saddle area, and motor or sensory changes in the lower limbs, atypical cases with isolated urinary symptoms are less recognized and pose significant diagnostic challenges.
Case Presentation: We report the case of a 46-year-old male who developed CES following lumbar microdiscectomy, presenting solely with urinary retention, without the classic signs of lower limb weakness or perineal sensory loss.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!