Management of postdural puncture headache with epidural blood patch in children

Ylönen, Paula; Kokki, Hannu

doi:10.1046/j.1460-9592.2002.00863.x

Cited by 49 publications

(37 citation statements)

References 18 publications

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“…19,20 Like adults, pediatric patients (girls > boys) may develop postdural puncture headache after diagnostic spinal punctures, spinal anesthesia, or inadvertent dural puncture after attempted epidural needle placement. An initial epidural blood patch using 0.2 to 0.3 mL·kg -1 of autologous blood completely abolished postural headache in more than 90%, 19,20 while a second epidural blood patch was effective in the remainder. In contrast to these observations, our patient did not sustain a needle punctureinduced dural injury, but rather suffered a larger (0.5 cm) durotomy as a complication of microdiscectomy.…”

Section: Discussionmentioning

confidence: 99%

Case report: Delayed presentation of postural headache in an adolescent girl after microscopic lumbar discectomy

Kundu

Sano

Pagel

2008

Can J Anesth/J Can Anesth

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Purpose: To discuss the diagnostic and therapeutic challenges presented by an adolescent girl with delayed postural headaches and photophobia that occurred three months after an apparently uncomplicated microscopic lumbar discectomy. Clinical features:A previously healthy girl was admitted to our hospital with a one-week history of an unremitting, frontalretroorbital postural headache and photophobia. Three months before admission, the patient had undergone a L5-S1 left hemilaminotomy and foraminotomy with microdiscectomy for excision of a herniated intervertebral disc. Conservative treatment failed to provide symptomatic relief. Cranial magnetic resonance imaging showed enhancement of the pachymeninges, consistent with intracranial hypotension. A chronic cerebrospinal leak was identified by high-resolution computed tomography (CT) myelography. Epidural blood patches were performed, with and without CT guidance, that provided temporary relief of the patient's symptoms; however, direct suture plication of the dural tear was eventually required for definitive treatment. Conclusion:This case emphasizes that delayed presentation of dural injury may occur after lumbar surgery and describes the potential therapeutic implications for this unusual complication.

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Section: Discussionmentioning

confidence: 99%

Case report: Delayed presentation of postural headache in an adolescent girl after microscopic lumbar discectomy

Kundu

Sano

Pagel

2008

Can J Anesth/J Can Anesth

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“…The diagnosis is often empirical and can be attributed to several variables other than CSF leakage [3,11]. An autologous "blood patch" (EBP) is standard secondtier therapy for persistent PDPH [3,4,[12][13][14]. The "patch," an outpatient procedure, consists of an epidural being performed; blood is then drawn under sterile conditions from the patient's arm vein and injected into the epidural space via the epidural needle to "seal" any CSF leakage from the suspected perforation site.…”

Section: Discussionmentioning

confidence: 99%

Perioperative headaches in an adolescent: a most complex situation

Campanini

Morrison

Ervin

2004

Journal of Adolescent Health

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“…The percentage of patients with persistent headache after an epidural blood patch was decreased when compared to patients receiving conservative treatment ( p = 0.03). An additional three retrospective chart review studies reported that the use of an epidural blood patch was effective in relieving post-lumbar puncture headaches in a high percentage of patients (Kokki, Sjovall, & Kokki, 2012; Ylonen & Kokki, 2002 A ; Ylonen & Kokki; 2002 B ). Four case studies also supported this trend (Cassady, Lederhaas, Turk, & Shanks, 2000; Kara et al, 2012; Liley et al, 2003; Roy, Vischoof, & Lavoie, 1995).…”

Section: Evidence Reviewmentioning

confidence: 99%

Evidence-Based Practice Recommendations to Prevent/Manage Post-Lumbar Puncture Headaches in Pediatric Patients Receiving Intrathecal Chemotherapy

Rusch

Schulta

Hughes

et al. 2014

J Pediatr Oncol Nurs

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Post lumbar puncture headaches (PLPH) are a known complication of lumbar puncture procedures. Children undergoing treatment for cancer often undergo multiple lumbar punctures placing them at increased risk for PLPHs. There are currently no guidelines for the prevention or management of PLPH in children. A team was therefore assembled to conduct a systematic review of the evidence in relationship to PLPHs in the pediatric population. Clinical questions were developed and used to guide the literature review. Twenty four articles were deemed appropriate for use and were evaluated utilizing the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) criteria. Based on the review of evidence, strong recommendations are made for the use of smaller needle sizes and for the use of pencil point needles during lumbar puncture procedures. Weak recommendations are made for needle orientation and positioning following the procedure as well as for interventions utilized to treat PLPH once they occur. There is a need for additional, pediatric-specific, studies to further examine the issue of PLPH prevention and treatment.

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Management of postdural puncture headache with epidural blood patch in children

Abstract: EBP gave some relief of symptoms in all children. No complications related to EBP were noticed.

Cited by 49 publications

References 18 publications

Case report: Delayed presentation of postural headache in an adolescent girl after microscopic lumbar discectomy

Case report: Delayed presentation of postural headache in an adolescent girl after microscopic lumbar discectomy

Perioperative headaches in an adolescent: a most complex situation

Evidence-Based Practice Recommendations to Prevent/Manage Post-Lumbar Puncture Headaches in Pediatric Patients Receiving Intrathecal Chemotherapy

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