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Postdural 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 PDFPersistent Post-dural Puncture Headaches One Year After Lumbar Puncture: A Case Report.
Cureus
November 2024
Department of Internal Medicine, Aga Khan University Hospital, Nairobi, KEN.
Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture.
View Article and Find Full Text PDFUltrasound-assisted and landmark-based nusinersen delivery in spinal muscular atrophy adults: A retrospective analysis.
Australas J Ultrasound Med
November 2024
Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy.
Introduction/purpose: Nusinersen, the first treatment approved for all spinal muscular atrophy (SMA) types, is administered intrathecally through lumbar puncture. We used ultrasound assistance or a landmark-based technique to access the lumbar intrathecal space in adult SMA patients. This study aimed to evaluate the technical success and adverse events (AEs) in such patients using either technique over a long observation period.
View Article and Find Full Text PDFAntiplatelet therapy is not associated with increased risk of complications after lumbar puncture.
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 PDFRacial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016-2020.
Anesth 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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