AI Article Synopsis
- Postdural puncture headache is a known complication from neuraxial techniques, often presenting similar symptoms as spontaneous intracranial hypotension (SIH), which can occur without any invasive procedures.
- SIH involves cerebrospinal fluid leaks that can happen spontaneously at various points along the neuraxis due to different mechanisms, leading to a decreased pressure in the cranial cavity.
- The article presents a case of a patient with a history of SIH who successfully underwent total knee arthroplasty using spinal anesthesia, while also exploring the pathophysiology, possible causes, treatments, and the overall safety of using neuraxial anesthesia in such patients.
Article Abstract
One commonly cited complication of neuraxial techniques is postdural puncture headache. Patients with spontaneous intracranial hypotension may present with a similar constellation of symptoms in the absence of any neuraxial instrumentation. The underlying physiology of spontaneous intracranial hypotension is similar to postdural puncture headache, but cerebrospinal fluid leaks may develop spontaneously at multiple levels of the neuraxis due to a variety of proposed mechanisms. We present a patient with a history of spontaneous intracranial hypotension who underwent a total knee arthroplasty under spinal anesthesia without complication and discuss the pathophysiology, proposed etiologies and treatments, and safety of neuraxial anesthesia in spontaneous intracranial hypotension.
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| http://dx.doi.org/10.1213/XAA.0000000000000990 | DOI Listing |
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