Chronic Postmyelogram Headache

Abstract

Following a myelogram a patient developed postiumbar puncture headache which was incapacitating and persistent 18 weeks after onseL Scans of the lumbar spine were performed 2 hours and 20 hours after lodinated 1 131 serum albumin (Risa-131) was injected through a cistema magna puncture. These demonstrated and localized a functioning cerebrospinal fluid leak through the dura. Surgical repair of the dural hole was made with prompt cure of the syndrome. (25:168-170, 1971)

Postural post‐dural puncture headache after spinal and epidural anaesthesia. A randomised, double‐blind study

“…The findings of a larger difference in backache between the groups compared to our study (20.1% and 9.2%) may also be explained by their use of a less traumatic spinal needle. They also found significantly shorter prepara- (15). tion time for SA and better quality of anaesthesia as only 2 patients (SA) compared to 17 patients (EA) had incomplete analgesia as well as less need for additional analgesia in the SA group.…”

A case of late diagnosis of chronic subdural hematoma following spinal anesthesia

“…Excessive dural puncture-related CSF leak following spinal anesthesia may lead to causal displacement of the brain. Intracranial bleeding may occur due to tension in the meningeal vessels during this displacement [4]. Post-dural puncture headache exceeding 48 h should suggest subdural hematoma or other intracranial bleeding [5].…”

“…analyzed cases of 1.260.000 spinal and 450.000 epidural blocks between 1990 and 99 and they reported only five cases of subdural haematoma [3]. Cerebrospinal fluid (CSF) leak persisting due to dural injury during puncture was thought to have led to bleeding with tension and tearing in meningeal vessels [4]. If subdural hematoma is not diagnosed early and treated appropriately it can result with mortality.…”

Cerebral Subdural Hematoma Following Spinal Anesthesia: Report of Two Cases

“…It is thought to be caused by a downward displacement of intracranial structures that causes cerebral hypotension and stretches the intracranial pain- sensitive structures [5]. About 90% of typical PDPH may occur within the first 72 hours and 66% within the first 48 hours of LP and usually subsides in a few days with bed rest and analgesia [6].…”