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Introduction: To report and discuss the spinal headache following insertion and removal of intrathecal drug delivery system in patients with chronic pain disorders.
Case Presentation: Intrathecal drug delivery system (IDDS) was initially used for the management of chronic malignant pain; it has since been used to manage pain from other nonmalignant conditions as well. Spinal headache is one of the complications during the trial, permanent placement and after removal of intrathecal drug delivery catheter systems. A 48-year-male patient with chronic pain disorder developed a refractory spinal headache after removing the intrathecal drug delivery system requiring a surgical intervention to resolve the problem.
Conclusions: Conservative management is successful in the vast majority of patients with spinal headache. Interventional procedures are required in a small fraction of patients for symptomatic relief.
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http://dx.doi.org/10.5812/aapm.29786 | DOI Listing |
NeuroSci
December 2024
Laboratory of Surgical Neuroanatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain.
Cauda equina nerve roots may become damaged during neuraxial anesthesia, and post-puncture headache may appear in the case of cerebrospinal fluid leakage if needle tips are deformed due to bone contact when several attempts are needed. Our aim was to verify the correlation between skin-transverse process distance (st) and skin-dural sac distance (d) for calculation of optimal angles in a free visual guide and as a reference for the maximal depth to be traversed by the needle. Randomly selected ex vivo samples ( = 10) were flexed to reproduce the position of the lumbosacral spine during spinal anesthesia.
View Article and Find Full Text PDFFront Pharmacol
December 2024
Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.
Background: Shivering, nausea and vomiting are common complications in cesarean section during neuraxial anesthesia. The aim of this study was to investigate the effects of prophylactic use of ondansetron on intraoperative shivering, nausea and vomiting in women undergoing cesarean section.
Methods: A total of 80 full-term parturients were randomly divided into the ondansetron group and the control group.
J Neurol
December 2024
Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Background: Lumbar puncture (LP) is a critical diagnostic procedure in the evaluation of neurological diseases. Although considered safe, complications such as post-dural puncture headache (PDPH), back pain, subdural hematoma or venous sinus thrombosis may still occur. Whether the use of antiplatelet therapy (APT) increases the risk of complications after LP, remains unclear.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
December 2024
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background: Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a rare central nervous system tumor, especially in adult females. Typically, it presents with leptomeningeal enhancements in the basal cisterns and spinal cord. However, varied radiological and pathological features can complicate the diagnosis, as the present case illustrates.
View Article and Find Full Text PDFAnesth Analg
December 2024
From the Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, Texas.
Background: Racial and ethnic disparities in health care delivery can lead to inadequate peripartum pain management and associated adverse maternal outcomes. An epidural blood patch (EBP) is the definitive treatment for moderate to severe postdural puncture headache (PDPH), a potentially debilitating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States.
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