Puerperal seizures after postdural puncture headache

Abstract

We propose that cerebral vasoconstriction is the mechanism for post-dural puncture headaches and seizures. Anatomic brain displacement may incite this vasospasm. This mechanism could also be the cause of cranial nerve palsies that have been described after dural puncture.

Posterior Reversible Encephalopathy Syndrome with Vasospasm in a Postpartum Woman After Postdural Puncture Headache Following Spinal Anesthesia

“…Previous studies have demonstrated that vasospasm can occur during the acute phase of PRES (16 -18). An earlier report described eight postpartum women with postdural puncture headache who developed cortical blindness and seizure (19); angiography and xenon flow studies performed in three of them showed diffuse cerebral artery vasospasm (19). In the current patient, diffuse cerebral artery vasospasm, possibly due to the traction of this vessel by anatomic brain displacement, could provide an explanation for the development of PRES after spinal anesthesia.…”

Postpartum Posterior Reversible Encephalopathy Syndrome – A Case that can Press Hard an Obstetrician

“…Clinical and radiological features of PRES include headache, encephalopathy, seizures, cortical visual changes, and parieto-occipital white matter edema visualized on neuroimaging modalities 12 . In this case, headache and convulsion in early post partum period without proteinuria might be due to cerebral venous sinus thrombosis, subarachnoid hemorrhage and postdural punctures seizures in the postpartum period 13 . The diagnosis of PRES was made following the typical radiological findings of bilateral, symmetrical cortical and subcortical vasogenic edema in combination with the characteristic presenting features.…”

Posterior Reversible Encephalopathy Syndrome after Intravenous Caffeine for Post–Lumbar Puncture Headaches: Fig 1.

“…[8][9][10][11] With this case report, we suggest adding multiple sclerosis and PDPH to the list of possible predisposing factors and IV caffeine to the list of trigger factors for PRES. …”