Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature

Zeidan, Ahed; Farhat, Oussama; Maaliki, H.; Baraka, Anis

doi:10.1016/j.ijoa.2005.07.001

Cited by 144 publications

(142 citation statements)

References 59 publications

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“…Surgeons and obstetricians must also be aware of the complication, since they are inevitably the first ones to be contacted when the condition sets in. And, since most headache cases are treated without a subsequent investigation, it is believed that the true incidence may be even higher than it has been published 21 .…”

Section: Discussionmentioning

confidence: 97%

“…In many cases presented in the literature, initial diagnosis was masked by a single diagnosis of headache after spinal anesthesia 13,14,[18][19][20][21] . According to a review of literature of 21 subdural hematoma cases after inadvertent dura mater puncture, the earliest diagnosis occurred two days after the epidural anesthesia and the latest occurred after 20 weeks 21 . This shows that in the case reported here, diagnosis was made as early as or even earlier, since clinical suspicion occurred after 48 hours of spinal puncture and after some hours of headache onset, confirmed by imaging examination.…”

Section: Discussionmentioning

confidence: 99%

“…This situation may lead to cardiac arrest or persistent neurological sequelae. The time elapsed from CSF loss leading to headache and the development of hematoma range from 2 hours to 44 days [21][22][23][24] . In this aspect, depending on the time of headache onset, its pathophysiological mechanism may be distinct.…”

Section: Discussionmentioning

confidence: 99%

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Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Bisinotto¹,

Dezena²,

Fabri³

et al. 2012

Rev. Bras. Anestesiol.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Bisinotto¹,

Dezena²,

Fabri³

et al. 2012

Rev. Bras. Anestesiol.

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“…It is possible that postdural puncture headache left untreated may be complicated by the development of subdural hematoma. 12 Patients developing a postdural puncture headache unrelieved by conservative measures, then we should plan for invasive measure. Tracheal stenosis is rare and late serious complication of prolong ventilation and misdiagnosed as bronchial asthma.…”

Section: Discussion-mentioning

confidence: 99%

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Paswan¹

2012

iosrphr

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-Tracheal stenosis is the most common late airway complication of post intubation/trachestomy resulted in hemodynamic deterioration and impairment of respiratory system mechanics. Post-dural puncture headache (PDPH) is well known complication of introduction of spinal/epidural needle in subarachanoid space. In this article, we present a very rare case report of a patient 18 year old male, diagnosis tuberculous meningitis(TBM) get prolong mechanical ventilation and dural puncture had developed tracheal stenosis and post-dural puncture headache . We describe a patient with PDPH and tracheal stenosis which was initially misdiagnosed as simple headache and asthma after prolonged tracheal intubation. Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. KEY WORD:-TBM .PDPH .TRACHEAL STENOSIS CASE HISTORY:-A 18 year-old male who presented with a 6-week history of headache and fever and a 8-hour history of inability to speak and alteration in level of consciousness. There was history of neck pain, occasional nausea /vomiting and no neck stiffness .He had no other remarkable past history of medical and surgical illness. Before presentation, he had been kept on various intravenous antibiotics in private hospitals, with no clinical improvement. Physical examination showed a young man in an altered level of consciousness with signs of meningeal irritation and had left spastic hemiparesis. The patient had progressive respiratory distress with rapid shallow breathing, while using all accessory muscles of respiration. He had a respiratory rate of 35 breaths min -1 , and a fluctuating arterial oxygen saturation of 70~80% with 10 L.min -1 of supplementary oxygen. The patient was ventilated with the synchronized intermittent mandatory ventilation with volume controlled mode selected. The ventilatory settings were as follows: FiO 2 0.40; respiratory rate 14 breaths/min; Tidal volume500ml; pressure support 12 cm H 2 O; positive end expiratory pressure (PEEP) 5 cm H 2 O.With above mentioned settings, the peak airway pressure (PIP) was 16 cm H 2 O, and the arterial blood gas parameters were satisfactory .A lumbar puncture was performed with 23 G spinal needle and produced opalescent cerebrospinal fluid (CSF) with CSF pressure of 14 cm of H20. The biochemical/microbiological features of CSF are :-Protein 80mg/dl; glucose 40mg/dl; WBC 75 /micro L, chiefly there was Lymphocyte (70%)and CSF acid fast and grams staining were negative . CSF culture was not sent .The computed tomography scan of brain showed obstructive hydrocephalus. These above mentioned feature was suggestive of tuberculous meningitis .He was placed immediate on antituberculous drugs and intravenous steroids and mannitol .He was successfully weaned off mechanical ventilatory support after 10 days. After first day of weaning patient experienced of headache and vertigo. Intensivist assumed that headache and vertigo is a part of TBM and symptoms will subside after few da...

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“…As there is no underlying pathology to undergone surgery, therapy is targeted to decrease the hematoma in spontaneous SSDHs. Several authors proposed that conservative management may be indicated when the severity of neurologic symptoms is less than grade D or better on the Frankel grading scale [10][11][12]. Since the patient did not show definite neurologic deficit, conservative treatment was the mode of choice, and complete resolution of the hematoma was obtained.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Subdural Hematoma Developed After Weightlifting: A case Report and Review of Literature

Park¹,

Lim²,

Yoo³

2011

OJCD

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Spontaneous spinal subdural hematoma is a rare disease. Several predisposing factors are reported including impaired clotting due to therapeutic anticoagulation or hematologic disorder, vascular anomaly, intraspinal tumor, and iatrogenic causes such as lumbar puncture or spinal anesthesia.We report a rare case of spontaneous spinal subdural hematoma developed after weightlifting in a healthy young man treated with conservative treatment.

show abstract

Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature

Cited by 144 publications

References 59 publications

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Spontaneous Spinal Subdural Hematoma Developed After Weightlifting: A case Report and Review of Literature

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