Postdural puncture headache (PDPH) is one of the most important complications of peripartum neuraxial analgesia. Loss of cerebrospinal fluid volume and pressure as well as compensatory intracranial vasodilation are assumed to be responsible. Potentially severe long-term sequelae necessitate the correct diagnosis of PDPH, exclusion of relevant differential diagnoses (with atypical symptoms and when indicated via imaging techniques) and rapid initiation of effective treatment. Nonopioid analgesics, caffeine and occasionally theophylline, gabapentin and hydrocortisone are the cornerstones of pharmacological treatment, while the timely placement of an autologous epidural blood patch (EBP) represents the gold standard procedure when symptoms persist despite the use of analgesics. Procedures using neural treatment are promising alternatives, especially when an EBP is not desired by the patient or is contraindicated. Interdisciplinary and interprofessional consensus standard procedures can contribute to optimization of the clinical management of this relevant complication.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00101-022-01171-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Triple-drug antibiotic therapy for disseminated nocardial abscess in the mediastinum and brain of an immunocompetent patient: a case report.
BMC Infect Dis
January 2025
Department of Oncology, General Hospital of Western Theatre Command, No. 270, Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan, 610000, People's Republic of China.
Background: Nocardia are widely present in nature and considered opportunistic pathogens. They can result in hematogenous spread infection through the ruptured skin or respiratory tract when the host's immune system is compromised. Currently, 119 species of Nocardia have been identified, with 54 capable of causing infections in humans.
View Article and Find Full Text PDFSuccessful venous thrombectomy for extensive cerebral venous and sinus thrombosis after failed diagnostic lumbar puncture.
Rofo
January 2025
Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
With an incidence of 2-5 per million adults, cerebral venous and sinus thrombosis (CVST) is a rarity in the spectrum of cerebrovascular diseases. The etiology and symptomatic presentation are heterogeneous and diverse. CSVT is, therefore, often underdiagnosed.
View Article and Find Full Text PDFPostdural puncture headache: Beyond the evidence.
Best Pract Res Clin Anaesthesiol
September 2024
Yale Medicine/Yale New Haven Health System, USA. Electronic address:
Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.
View Article and Find Full Text PDFAcute-Onset Bilateral External and Internal Ophthalmoplegia: A Rare Presentation of Miller Fisher Syndrome in a Pediatric Patient.
Cureus
December 2024
Pediatrics, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Miller Fisher syndrome (MFS) is a rare Guillain-Barré syndrome (GBS) variant. The global incidence of GBS is approximately one to two in 100,000 children (aged 0 to 15 years) per year. Miller Fisher syndrome represents a further small subset, with the incidence being one to two in 1,000,000 children.
View Article and Find Full Text PDFIatrogenic intracranial hypotension complicated to dural venous sinus thrombosis and lobar hemorrhage: A case report.
Radiol Case Rep
March 2025
Resident at Radiology Department, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
Iatrogenic intracranial hypotension is a known complication of spinal anesthesia that can lead to more severe conditions, such as dural or cerebral venous sinus thrombosis (CVST). This report presents a case of intracranial hypotension in a young woman after lumbar anesthesia for a cesarean section that was complicated by CVST and subsequently by lobar hemorrhage, clinically presenting with severe headache and seizures. The diagnosis was made via cerebral magnetic resonance (MR) imaging, and the patient was treated medically.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!