Korean Journal of Anesthesiology

The Korean Society of Anesthesiologists (대한마취통증의학회)
권호 표지

Spontaneous Intracranial Hypotension after Post-dural Puncture Headache - A case report -

경막천자 후 두통으로 오인된 자발성 두개내 저압 - 증례보고-

Kim, Deok-Kyu;Kim, Dong-Chan;Lee, Jeong-Woo;Lim, Hyung-Sun;Son, Ji-Seon
김덕규;김동찬;이정우;임형선;손지선

  • Published : 20070200
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Abstract

Spontaneous intracranial hypotension (SIH) occurs without any preceding events such as lumbar puncture, surgery, trauma, or medical illness. It is characterized by a postural headache that is aggravated whilst in the erect or sitting position, and is relieved in the supine position. A postural headache usually resolves either spontaneously or with conservative treatment. An epidural block is a very important treatment for lumbago and is mostly performed for pain control. However, an incidental dural puncture is possible during epidural block and anesthesiology and pain medicine doctor should be familiar with an epidural block. Radioisotope cisternography is a highly sensitive, reliable and safe technique for confirming of the presence and location of cerebrospinal fluid (CSF) leakage. We report two cases of spontaneous intracranial hypotension that was diagnosed by SIH through cisternography in a situation where the post-dural puncture headache was primarily suspected as being the cause. If a postural headache occurs after an epidural block through an epidural needle without CSF leakage, other causes e.g. dural puncture need to be identified.

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References

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