Differentiating the headache of cerebral venous thrombosis from post-dural puncture: A headache for anaesthesiologists

Sherfudeen, Khaja Mohideen; Ramasamy, Gurumoorthi; Kaliannan, Senthil Kumar; Dammalapati, Pavan Kumar

doi:10.4103/0019-5049.181609

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…The authors suggested that patients with persistent or progressive headache after lumbar puncture should be reassessed. Sherfudeen et al ( 2016 ) described a 33-year-old male who underwent fissurectomy under spinal anesthesia and had no remarkable discomfort after surgery. The patient was discharged the next day.…”

Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Luo

Tian

Wang

2018

Front. Aging Neurosci.

126

145

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Cerebral venous thrombosis (CVT), also called cerebral venous sinus thrombosis (CVST), is a cerebrovascular disease with diverse clinical manifestations that often affects young adults, women of childbearing age, and children. It's most common clinical manifestations are headache, seizures, altered consciousness, and neurological focal signs on physical examination. CVT can manifest as a single symptom, or it can present as a syndrome consisting of multiple symptoms. This non-specific clinical picture makes diagnosing CVT difficult. Although the mortality rate of CVT has been significantly reduced by improvements in treatment and diagnostic techniques, the mortality rate of severe CVT remains as high as 34.2%. Survivors of this type of CVT have varying degrees of residual symptoms and are not able to return to their previous work. Hence, we performed a comprehensive literature search in the PubMed, EMBASE, and Medline databases to review the diagnosis and treatment of CVT.

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Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Luo

Tian

Wang

2018

Front. Aging Neurosci.

126

145

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“…The role of past history of PDPH on occurrence of PDPH is conflicting. [ 11 17 18 19 20 ] An increased incidence of PDPH was reported in patients with a history of PDPH (19%) compared with no such history (6.9%). [ 17 ] No relationship was found between history of past PDPH and occurrence of PDPH.…”

Section: Discussionmentioning

confidence: 99%

Effect of reinsertion of the spinal needle stylet after spinal anaesthesia procedure on post dural puncture headache in women undergoing caesarean delivery

et al. 2020

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Background and Aims: Post dural puncture headache (PDPH) following caesarean delivery (CD) is a cause for concern for anaesthesiologists. We aimed to study the effect of reinsertion of the stylet after spinal anaesthesia procedure, prior to spinal needle removal, on the incidence of PDPH in women undergoing CD. We also evaluated the risk factors associated with PDPH. Methods: In this randomised, double-blind study in a tertiary care hospital, 870 American Society of Anesthesiologists (ASA) II/III women undergoing CD under spinal anaesthesia were randomly divided into-GroupA (n = 435): stylet reinsertion before spinal needle removal and Group B (n = 435): spinal needle removal without stylet reinsertion. All patients were questioned for occurrence of PDPH at various time-points. Statistical calculations were done using Statistical Package for the Social Sciences (SPSS) 17 version program for Windows. Results: Sixty-two (7.1%) patients developed PDPH; 27 (6.2%) patients with stylet reinsertion and 35 (8.0%) patients in those with no stylet reinsertion; P = 0.389. The onset of headache was significantly delayed in patients with stylet reinsertion (16.2 ± 6.7 and 13.2 ± 4.3 h, respectively); P = 0.041 and they had greater severity of PDPH compared with those with no stylet reinsertion; P = 0.002. Factors significantly associated with PDPH were hypothyroidism, tea habituation, number of skin punctures and needle redirections, first pass success rate, occurrence of paraesthesia and contact with bone, intraoperative hypotension and time to ambulation. Conclusions: Reinsertion of the stylet before spinal needle removal did not influence the incidence of PDPH. The onset of PDPH was delayed and the severity of headache was greater in women in whom reinsertion of the stylet was done.

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“…However, this safe technique can still become unsafe and result in unanticipated morbidity and at times, mortality. Published in this issue of IJA are reports of complications attributed to CNBs, ranging from post-dural puncture headache (PDPH) to pneumocephalus, arachnoiditis, epidural haematoma, rectal perforation and aphonia[ 2 3 4 5 6 7 ] clearly indicating their occurrence, despite the professed improvements in the field. This reinforces the need for adopting meticulous measures while performing these simple procedures.…”

mentioning

confidence: 99%

“…The six reports[ 2 3 4 5 6 7 ] published in this issue highlight the various possible complications that can follow the ‘simple’ procedure of spinal anaesthesia. Hence, it is prudent that every anaesthesiologist adheres to strict protocols, follows the guidelines, incorporates aseptic principles, follows-up the patients in the post-operative period, detects the complications early and treats them aggressively and appropriately.…”

mentioning

confidence: 99%

Central neuraxial blocks: Complacency begets complications

Balavenkatasubramanian

2016

Indian J Anaesth

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Differentiating the headache of cerebral venous thrombosis from post-dural puncture: A headache for anaesthesiologists

Cited by 4 publications

References 6 publications

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Effect of reinsertion of the spinal needle stylet after spinal anaesthesia procedure on post dural puncture headache in women undergoing caesarean delivery

Central neuraxial blocks: Complacency begets complications

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