Blood Patch, Epidural
Post-Dural Puncture Headache
Cerebrospinal Fluid Pressure
Cerebrospinal Fluid Otorrhea
Cerebrospinal Fluid Rhinorrhea
Postpartum headache after epidural blood patch: investigation and diagnosis. (1/44)Use of an epidural blood patch to treat spinal headache after accidental dural puncture is well recognized. The high success rate associated with this practice has been questioned and it is not uncommon for patients to suffer recurring headaches after a supposedly successful blood patch. We describe a patient in labour who suffered accidental dural puncture, and whose headache was treated twice with an epidural blood patch. Despite this, the headache persisted. The case highlights the difficulty in the diagnosis of headache in the postnatal period in patients who have had regional analgesia and the importance of considering an alternative pathology, even if epidural blood patching has been successful. In this case, a diagnosis of cortical vein thrombosis was made. The incidence, presentation, aetiology and treatment of this rare condition is described. (+info)
Effectiveness of epidural blood patch in the management of post-dural puncture headache. (2/44)BACKGROUND: Lumbar epidural blood patch (EBP) is a common treatment of post-dural puncture headache, but its effectiveness and mode of action remain a matter of debate. The aim of this study was to assess both the effectiveness and the predictive factors of failure of EBP on severe post-dural puncture headache. METHODS: This prospective observational study includes all patients treated in the authors' hospital with EBP for incapacitating post-dural puncture headache, from 1988 to 2000. The EBP effect was classified into complete relief (disappearance of all symptoms), incomplete relief of symptoms (clinically improved patients who recovered sufficiently to perform normal daily activity), and failure (persistence of severe symptoms). The following data were analyzed using a logistic regression to identify predictive factors of failure of EBP: (1) patient characteristics; (2) circumstances of dural puncture; (3) delay between dural puncture and EBP; and (4) the volume of blood injected for EBP. RESULTS: A total of 504 patients were analyzed. The frequency rates of complete relief, incomplete relief of symptoms, and failure after EBP were 75% (n = 377), 18% (n = 93), and 7% (n = 34), respectively. In a multivariate analysis, only the diameter of the needle used to perform dura mater puncture (odds ratio = 5.96; 95% confidence interval, 2.63-13.47; P < 0.001) and a delay in EBP less than 4 days (odds ratio = 2.63; 95% confidence interval, 1.06-6.51; P = 0.037) were independent significant risk factors for a failure of EBP. CONCLUSIONS: Epidural blood patch is an effective treatment of severe post-dural puncture headache. Its effectiveness is decreased if dura mater puncture is caused by a large bore needle. (+info)
Subdural haematoma after dural puncture headache treated by epidural blood patch. (3/44)Subdural haematoma is a well-documented complication of accidental dural puncture, and is thought to be preventable by prompt treatment with an epidural blood patch. An accidental dural puncture occurred in a 39-yr-old primagravida during the siting of an epidural catheter for pain relief in labour. Twenty hours after the puncture, the mother developed a typical postdural puncture headache, which increased in severity over the subsequent 24 h. An epidural blood patch was performed at 48 h, and this initially relieved the headache. After discharge from hospital, and 14 days after the dural puncture, the headache recurred, together with expressive dysphasia, poor co-ordination and sensory loss in the right arm. A magnetic resonance imaging scan demonstrated a left sided subdural haematoma, which was drained successfully with complete recovery. (+info)
Postpartum cerebral ischaemia after accidental dural puncture and epidural blood patch. (4/44)Puerperal women are reported to have a rate of cerebral infarction 13 times greater than non-pregnant females. We report a case of cerebral ischaemia in a 30-yr-old healthy parturient after epidural analgesia for labour, complicated by dural puncture treated with two epidural blood patches. Investigations showed the development of cerebral ischaemia on postpartum day 14. A transcranial Doppler ultrasonography showed vasospasm of the left middle cerebral artery still present at 3-month follow-up. At 1-yr follow-up, the patient had homonymous hemianopsia. We discuss the possible causative mechanism of the cerebral ischaemia in relation to the dural puncture and epidural blood patch. (+info)
Recurrent post-partum seizures after epidural blood patch. (5/44)There are many causes for headaches after childbirth. Even though postdural puncture headache (PDPH) has to be considered in a woman with a history of difficult epidural anaesthesia, pre-eclampsia should always be excluded as an important differential diagnosis. We report a case with signs of late-onset pre-eclampsia where administration of an epidural blood patch (EBP) was associated with eclampsia. A hypothetical causal relationship between the EBP and seizures was discarded on the basis of evidence presented in this report. (+info)
Post-dural puncture headache: pathogenesis, prevention and treatment. (6/44)Spinal anaesthesia developed in the late 1800s with the work of Wynter, Quincke and Corning. However, it was the German surgeon, Karl August Bier in 1898, who probably gave the first spinal anaesthetic. Bier also gained first-hand experience of the disabling headache related to dural puncture. He correctly surmised that the headache was related to excessive loss of cerebrospinal fluid (CSF). In the last 50 yr, the development of fine-gauge spinal needles and needle tip modification, has enabled a significant reduction in the incidence of post-dural puncture headache. Though it is clear that reducing the size of the dural perforation reduces the loss of CSF, there are many areas regarding the pathogenesis, treatment and prevention of post-dural puncture headache that remain contentious. How does the microscopic pattern of collagen alignment in the spinal dura affect the dimensions of the dural perforation? How do needle design, size and orientation influence leakage of CSF through the dural perforation? Can pharmacological methods reduce the symptoms of post-dural puncture headache? By which mechanism does the epidural blood patch cure headache? Is there a role for the prophylactic epidural blood patch? Do epidural saline, dextran, opioids and tissue glues reduce the rate of CSF loss? This review considers these contentious aspects of post-dural puncture headache. (+info)
In vitro effects of local anaesthetics on the thromboelastographic profile of parturients. (7/44)BACKGROUND: Post-dural puncture headache can be an incapacitating complication of obstetric epidural analgesia/anaesthesia and early or prophylactic epidural blood patch (EBP) is one of the treatment options. Although local anaesthetic (LA) agents have been shown to have anticoagulation effects in vitro, peri-partum women are known to be hypercoagulable. We postulated that the presence of residual LA might not result in impaired haemostasis of the EBP in parturients. METHODS: Blood samples from 10 healthy term parturients were subjected to thromboelastography after the addition of four different LA (lidocaine, bupivacaine, levobupivacaine, and ropivacaine) preparations. RESULTS: There was a significant reduction in reaction (R) and coagulation (K) time (P<0.001, P<0.05) and an increase in alpha degrees angle (P<0.01) when comparing undiluted blood with the saline control group. Maximum amplitude (MA) and clot lysis (Ly30) did not change significantly despite the 50% dilution. The thromboelastographic parameters of all four LA-treated groups were no different from their saline controls and from each other. CONCLUSION: At clinical dosages, LA did not cause any hypocoagulable changes on the thromboelastographic profile of healthy parturients. (+info)
Efficacy of a prophylactic epidural blood patch in preventing post dural puncture headache in parturients after inadvertent dural puncture. (8/44)BACKGROUND: Postdural puncture headache (PDPH) occurs in up to 80% of parturients who experience inadvertent dural puncture during epidural catheter placement. The authors performed a randomized double blind study to assess the effect of prophylactic epidural blood patch on the incidence of PDPH and the need for therapeutic epidural blood patch. METHODS: Sixty-four parturients who incurred inadvertent dural puncture were randomized to receive a prophylactic epidural blood patch with 20 ml autologous blood (prophylactic epidural blood patch group) or a sham patch (sham group). Subjects were evaluated daily for development of PDPH for a minimum of 5 days after dural puncture. Those who developed a PDPH were followed daily for a minimum of 3 days after resolution of the headache. Subjects with moderate headaches who reported difficulties performing childcare activities and all those with severe headaches were advised to receive a therapeutic epidural blood patch. RESULTS: Eighteen of 32 subjects in each group (56%) developed PDPH. Therapeutic blood patch was recommended in similar numbers of patients in each group. The groups had similar onset time of PDPH, median peak pain scores, and number of days spent unable to perform childcare activities as a result of postural headache. The median duration of PDPH, however, was shorter in the prophylactic epidural blood patch group. CONCLUSIONS: A decrease in the incidence of PDPH or the need for criteria-directed therapeutic epidural patch was not detected when a prophylactic epidural blood patch was administered to parturients after inadvertent dural puncture. However, prophylactic epidural blood patch did shorten the duration of PDPH symptoms. (+info)
Some common symptoms of intracranial hypotension include:
1. Headache: This is the most common symptom of intracranial hypotension, and it can range from mild to severe.
2. Nausea and vomiting: Patients with intracranial hypotension may experience nausea and vomiting, especially during periods of increased intracranial pressure.
3. Dizziness and vertigo: Intracranial hypotension can cause dizziness and vertigo due to the changes in pressure within the cranium.
4. Fatigue and lethargy: Patients with intracranial hypotension may feel tired, weak, and lethargic due to the decreased pressure on the brain.
5. Confusion and disorientation: In severe cases of intracranial hypotension, patients may experience confusion, disorientation, and difficulty concentrating.
If left untreated, intracranial hypotension can lead to a range of complications, including:
1. Cerebral edema (swelling of the brain): The decreased pressure within the cranium can cause fluid to accumulate in the brain, leading to swelling and increased intracranial pressure.
2. Seizures: Intracranial hypotension can increase the risk of seizures, especially in patients with a history of seizure disorders.
3. Stroke: In severe cases of intracranial hypotension, there is a risk of stroke due to the decreased blood flow to the brain.
4. Hydrocephalus (fluid accumulation in the brain): Intracranial hypotension can cause fluid to accumulate in the brain, leading to hydrocephalus and increased intracranial pressure.
The diagnosis of intracranial hypotension is based on a combination of clinical symptoms, physical examination findings, and imaging studies. Imaging studies, such as CT or MRI scans, are used to confirm the diagnosis and evaluate the extent of any damage to the brain.
Treatment of intracranial hypotension depends on the underlying cause and severity of symptoms. In mild cases, treatment may involve observation and supportive care, such as hydration and pain management. In more severe cases, surgical intervention may be necessary to relieve pressure on the brain and repair any damage to the cranium or dura mater.
In conclusion, intracranial hypotension is a rare but potentially life-threatening condition that can have significant consequences if left untreated. Prompt diagnosis and treatment are essential to prevent complications and improve outcomes for patients with this condition.
Post-dural puncture headaches are usually characterized by a severe, throbbing pain that is often worse when standing up or bending forward. They can also be accompanied by nausea, vomiting, and sensitivity to light and sound. In some cases, the headache may be accompanied by a feeling of stiffness in the neck or back.
The symptoms of a post-dural puncture headache typically begin within 24 hours of the procedure and can last for several days. Treatment for this type of headache usually involves medication, such as pain relievers or anti-inflammatory drugs, and fluid replacement to help restore the balance of CSF in the body. In severe cases, a blood patch may be necessary to seal the puncture site and prevent further leakage of CSF.
Primary headache disorders are those that are not caused by another medical condition or injury, and include:
1. Migraine: a severe, debilitating headache that can last for hours or even days, often accompanied by sensitivity to light and sound, nausea, and vomiting.
2. Tension headache: a common type of headache that is often described as a dull, squeezing pain on both sides of the head.
3. Cluster headache: a rare and intense form of headache that occurs in clusters or cycles, typically lasting several weeks or months.
4. Sinus headache: a type of headache caused by inflammation or infection in the sinuses.
5. Trigeminal neuralgia: a chronic pain disorder that affects the nerves in the face and head.
Secondary headache disorders are those that are caused by another medical condition or injury, such as:
1. Medication overuse headache: a type of headache that develops as a result of taking too much pain medication.
2. Hormonal headache: a type of headache that occurs due to changes in hormone levels, such as during menstruation or menopause.
3. Headache caused by underlying medical conditions, such as stroke, tumors, or sinusitis.
4. Headache caused by trauma or injury, such as whiplash or a concussion.
Headache disorders can have a significant impact on an individual's quality of life, and can affect their ability to work, sleep, and participate in daily activities. Treatment for headache disorders depends on the underlying cause, but may include medication, lifestyle changes, and alternative therapies such as acupuncture or biofeedback.
Subdural effusion is a condition where there is an accumulation of fluid between the dura mater, the protective covering of the brain, and the skull. This fluid can be cerebrospinal fluid (CSF) or blood. The excess fluid can cause pressure on the brain, leading to various symptoms such as headaches, nausea, vomiting, and confusion.
There are several causes of subdural effusion, including:
1. Traumatic brain injury: A blow to the head can cause the veins in the dura mater to tear, leading to bleeding or fluid accumulation.
2. Infections such as meningitis or encephalitis: These infections can cause inflammation and fluid buildup in the dura mater.
3. Tumors: Both benign and malignant tumors can cause subdural effusion by obstructing the flow of CSF or by causing inflammation.
4. Hydrocephalus: This is a condition where there is an abnormal accumulation of CSF in the brain, leading to increased intracranial pressure and fluid buildup in the dura mater.
5. Spinal or cerebral vasculature disorders: Conditions such as stroke, aneurysm, or arteriovenous malformation can cause subdural effusion by disrupting the flow of blood or CSF.
Symptoms of subdural effusion can vary depending on the location and severity of the fluid accumulation. Common symptoms include:
1. Headache: This is the most common symptom, which can range from mild to severe.
2. Nausea and vomiting: Patients may experience nausea and vomiting due to the pressure on the brain.
3. Confusion and disorientation: Subdural effusion can cause confusion, disorientation, and difficulty with concentration and memory.
4. Weakness or numbness: Patients may experience weakness or numbness in the arms or legs due to the pressure on the brain.
5. Seizures: In some cases, subdural effusion can cause seizures.
Diagnosis of subdural effusion typically involves a combination of physical examination, imaging studies, and laboratory tests. Imaging studies, such as CT or MRI scans, are used to confirm the presence of fluid accumulation in the subdural space. Laboratory tests, such as electrolyte panels and blood counts, may be ordered to rule out other conditions that can cause similar symptoms.
Treatment of subdural effusion depends on the underlying cause and severity of the condition. In some cases, conservative management with supportive care, such as fluid and electrolyte replacement, pain management, and seizure control, may be sufficient. Surgical intervention may be necessary in more severe cases or if there is no response to conservative management.
Surgery for subdural effusion involves draining the excess fluid and repairing any underlying blood vessel ruptures or tears. In some cases, a shunt may be inserted to help drain excess fluid and relieve pressure on the brain. Postoperatively, patients may require close monitoring in an intensive care unit and may need to undergo rehabilitation to regain lost function and mobility.
Prevention of subdural effusion is challenging, as many of the underlying causes are unpredictable and unavoidable. However, prompt recognition and management of the condition can help prevent complications and improve outcomes. In some cases, prophylactic measures such as corticosteroid therapy or anticonvulsant medications may be used to reduce the risk of developing subdural effusion.
Overall, subdural effusion is a serious medical condition that requires prompt recognition and management to prevent complications and improve outcomes. A multidisciplinary approach involving neurologists, neurosurgeons, rehabilitation specialists, and other healthcare professionals may be necessary to provide comprehensive care for patients with this condition.
There are several types of headaches, including:
1. Tension headache: This is the most common type of headache and is caused by muscle tension in the neck and scalp.
2. Migraine: This is a severe headache that can cause nausea, vomiting, and sensitivity to light and sound.
3. Sinus headache: This type of headache is caused by inflammation or infection in the sinuses.
4. Cluster headache: This is a rare type of headache that occurs in clusters or cycles and can be very painful.
5. Rebound headache: This type of headache is caused by overuse of pain medication.
Headaches can be treated with a variety of methods, such as:
1. Over-the-counter pain medications, such as acetaminophen or ibuprofen.
2. Prescription medications, such as triptans or ergots, for migraines and other severe headaches.
3. Lifestyle changes, such as stress reduction techniques, regular exercise, and a healthy diet.
4. Alternative therapies, such as acupuncture or massage, which can help relieve tension and pain.
5. Addressing underlying causes, such as sinus infections or allergies, that may be contributing to the headaches.
It is important to seek medical attention if a headache is severe, persistent, or accompanied by other symptoms such as fever, confusion, or weakness. A healthcare professional can diagnose the cause of the headache and recommend appropriate treatment.
The term "otorrhea" specifically refers to the leakage of fluid from the inner ear into the middle ear, which can be caused by various conditions such as a tear in the eardrum, a perforated eardrum, or a hole in the bone around the inner ear. When CSF flows into the middle ear, it can cause a range of symptoms due to the pressure difference between the two compartments and the presence of CSF in the middle ear.
CSF otorrhea can be caused by a variety of factors, including:
1. Trauma to the head or ear
2. Infections such as meningitis or inner ear infections
3. Tumors or cysts in the inner ear or brain
4. Agerelated wear and tear on the eardrum or other structures
5. Certain medical conditions such as osteoporosis or Eustachian tube dysfunction.
Diagnosis of CSF otorrhea typically involves a combination of physical examination, imaging studies such as CT or MRI scans, and hearing tests. Treatment depends on the underlying cause of the condition and may involve antibiotics, surgery to repair any tears or defects in the eardrum or other structures, or observation and monitoring.
In summary, CSF otorrhea is an abnormal flow of cerebrospinal fluid from the inner ear into the middle ear, which can cause a range of symptoms including hearing loss, tinnitus, balance difficulties, and facial weakness or paralysis. It can be caused by various factors and diagnosed through a combination of physical examination, imaging studies, and hearing tests. Treatment depends on the underlying cause of the condition.
Causes of cerebrospinal fluid rhinorrhea may include:
1. Skull fracture or depression: Trauma to the skull can cause a tear in the meninges, the membranes that cover the brain and spinal cord, leading to CSF leakage.
2. Spinal tap or lumbar puncture: This medical procedure can sometimes result in a small amount of CSF leaking into the nasopharynx.
3. Infection: Meningitis or encephalitis can cause CSF to leak into the nose and throat.
4. Brain tumors: Tumors in the brain can cause CSF to leak out of the sinuses or nose.
5. Cerebral aneurysm: A ruptured aneurysm in the brain can cause CSF to leak out of the nose or sinuses.
6. Vasculitic diseases: Conditions such as Wegener's granulomatosis or Takayasu arteritis can cause inflammation and damage to blood vessels, leading to CSF leakage.
7. Congenital conditions: Some individuals may have a congenital skull defect or abnormality that allows CSF to escape into the nasopharynx or sinuses.
Symptoms of cerebrospinal fluid rhinorrhea may include:
1. Clear, colorless discharge from the nose or sinuses
2. Thick, sticky discharge or pus in the nose or sinuses
3. Headache, fever, or neck stiffness
4. Nausea, vomiting, or dizziness
5. Weakness or numbness in the face, arms, or legs
6. Seizures or convulsions
7. Change in mental status or consciousness
Diagnosis of cerebrospinal fluid rhinorrhea typically involves a combination of physical examination, imaging studies such as CT or MRI scans, and laboratory tests to rule out other possible causes of nasal discharge. Treatment depends on the underlying cause of the condition and may include antibiotics, anti-inflammatory medications, or surgery to repair any defects or obstructions in the skull or sinuses.
Some common puerperal disorders include:
1. Puerperal fever: This is a bacterial infection that can occur during the postpartum period, usually caused by Streptococcus or Staphylococcus bacteria. Symptoms include fever, chills, and abdominal pain.
2. Postpartum endometritis: This is an inflammation of the lining of the uterus that can occur after childbirth, often caused by bacterial infection. Symptoms include fever, abdominal pain, and vaginal discharge.
3. Postpartum bleeding: This is excessive bleeding that can occur during the postpartum period, often caused by tears or lacerations to the uterus or cervix during childbirth.
4. Breast engorgement: This is a common condition that occurs when the breasts become full and painful due to milk production.
5. Mastitis: This is an inflammation of the breast tissue that can occur during breastfeeding, often caused by bacterial infection. Symptoms include redness, swelling, and warmth in the breast.
6. Postpartum depression: This is a mood disorder that can occur after childbirth, characterized by feelings of sadness, anxiety, and hopelessness.
7. Postpartum anxiety: This is an anxiety disorder that can occur after childbirth, characterized by excessive worry, fear, and anxiety.
8. Urinary incontinence: This is the loss of bladder control during the postpartum period, often caused by weakened pelvic muscles.
9. Constipation: This is a common condition that can occur after childbirth, often caused by hormonal changes and decreased bowel motility.
10. Breastfeeding difficulties: These can include difficulty latching, painful feeding, and low milk supply.
It's important to note that not all women will experience these complications, and some may have different symptoms or none at all. Additionally, some complications may require medical attention, while others may be managed with self-care measures or support from a healthcare provider. It's important for new mothers to seek medical advice if they have any concerns about their physical or emotional well-being during the postpartum period.
Epidural blood patch
Cerebrospinal fluid leak
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Combined spinal and epidural anaesthesia
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Route of administration
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Failed back syndrome
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- Oedit, R., van Kooten, F., Bakker, S.L.M. and Dippel, D.W.J. (2005) Efficacy of the Epidural Blood Patch for the Treatment of Post Lumbar Puncture Headache BLOPP: A Randomised, Observer-Blind, Controlled Clinical Trial. (scirp.org)
- A post-dural puncture headache (PDPH) is a rare but significant complication of epidural or spinal anesthesia which is definitively treated with an epidural blood patch (EBP) procedure. (pauls.place)
- Sindhi et al concluded that patients with degenerative spondylolisthesis may be at higher risk for dural puncture due to stretching of the dura and contraction of the epidural space at the translated spinal level. (medscape.com)
- 19. Pneumocephalus after inadvertent dural puncture during epidural anesthesia. (nih.gov)
- With regard to treatment prevalence, 40.4% of the patients (n=8651) had conservative medical management, 46.6% (n=9987) received epidural blood patch repair, 9.6% required surgical repair (n=2066), and 3.3% (n=710) had lumbar drain/puncture. (nih.gov)
- The injection of autologous blood into the epidural space either as a prophylactic treatment immediately following an epidural puncture or for treatment of headache as a result of an epidural puncture. (nih.gov)
- PDPH is a known complication of unintentional dural puncture during epidural analgesia or intentional dural puncture for spinal anesthesia or for diagnostic or interventional neuraxial procedures. (medscape.com)
- The day after the second intrathecal injection, she visited an emergency department in the United States for positional headache and received an epidural blood patch for presumed postlumbar puncture cerebrospinal fluid (CSF) leak. (cdc.gov)
- Postdural puncture headache (PDPH) is an important complication of obstetric epidural anaesthesia and analgesia. (dspace-express.com)
- The classical features of PDPH according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) include headache that occurs within 5 days of lumbar puncture (LP), that is aggravated with standing or sitting position and relieved with lying down, and remits spontaneously within 2 weeks, or after sealing of the leak with epidural lumbar patch [ 2 ]. (biomedcentral.com)
- POSTDURAL puncture headache (PDPH) is a complication of spinal anesthesia and unintentional dural puncture during attempted epidural anesthesia. (silverchair.com)
- Norris MC, Kalustian A, Salavati S. Epidural Blood Patch for Postdural Puncture Headache in a Patient With Coronavirus Disease 2019: A Case Report. (bu.edu)
- Pneumocephalus, on the other hand, is a rare and potentially serious complication of epidural anesthesia, which is most often caused by accidental puncture of the dura with the introduction of air into intrathecal space. (biomedcentral.com)
- In most cases, headache following epidural puncture is due to post-dural puncture headache (PDPH) characterized by cerebrospinal fluid leakage from the dural puncture resulting in low intracranial pressure [ 1 ]. (biomedcentral.com)
- Epidural puncture was performed in the L4-L5 intervertebral space with the patient in the sitting position. (biomedcentral.com)
- At that time, differential diagnosis for her new onset headache and neck pain post-difficult epidural puncture included subarachnoid puncture with acute loss of cerebrospinal fluid (CSF), post-dural puncture headache and pneumocephalus. (biomedcentral.com)
- Patients with this condition may present for epidural steroid injection, epidural blood patch, or epidural analgesia. (medscape.com)
- She requested epidural analgesia. (silverchair.com)
- Analgesia was maintained with a continuous epidural infusion of bupivacaine 0.125% and fentanyl 2.5 μg/ml at 10 ml/h. (silverchair.com)
- Epidural anesthesia is commonly used for analgesia during labor, and headache is a common complaint following this procedure. (biomedcentral.com)
- We present the case of a 19-year-old Hispanic female who developed a severe frontal headache and neck pain eight hours following epidural catheter placement to deliver analgesia during labor. (biomedcentral.com)
- Here we present the case of a 19-year-old female who developed pneumocephalus after epidural catheter placement to deliver analgesia during labor. (biomedcentral.com)
- For the management of labor pain when she had reached about 3 cm of cervical dilatation, epidural analgesia was requested. (biomedcentral.com)
- Though she was experiencing headaches and neck pain, the epidural analgesia was noted to be effective for the management of labor pain and was continued. (biomedcentral.com)
- Taken time to educate the patient on epidural analgesia so Mrs. Smith could make an informed decision. (nih.gov)
- Mentioned that while epidurals in childbirth are seen as optional or left to the patients discretion, for thoracotomy epidural analgesia is a standard of care to reduce the incidence of post-thoracotomy pain. (nih.gov)
- Low-level electrical impulses, delivered directly into the spinal cord through the SCS that is inserted in the epidural space, interfere with the direct transmission of pain signals traveling along the spinal cord to the brain. (epain.org)
- We describe a case of PDPH after unsuccessful epidural placement, followed by successful combined spinal-epidural placement. (silverchair.com)
- A successful combined spinal-epidural was then placed at L4-L5 using an 18-gauge Weiss epidural needle with the bevel inserted perpendicular to the dural fibers and using the loss of resistance to air technique. (silverchair.com)
- This patient's headache was resolved and intrathecal catheter remained intact after this blood patch. (scirp.org)
- She was discharged after her headache improved but subsequently received 2 blood patches in the outpatient setting for recurrent headaches. (cdc.gov)
- Other theories include hypersensitivity to substance P, compensatory vasodilation of intracranial blood vessels in order to maintain a constant intracranial volume (Monro-Kellie doctrine), and relative CSF hypovolemia resulting from persistent CSF leakage of CSF causing an orthostatic type of headache [ 8 ]. (biomedcentral.com)
- Although a rare complication and an uncommon cause of headache following epidural anesthesia, a high index of suspicion must remain for pneumocephalus as it may cause significant morbidity and, in some cases, be potentially life-threatening. (biomedcentral.com)
- 8 h following epidural catheter placement, she complained of severe frontal headache and neck pain. (biomedcentral.com)
- You have a headache that gets worse when you sit up, especially if you have recently had a head injury, surgery, or childbirth involving epidural anesthesia. (medlineplus.gov)
- Dodd, J.E., Efird, R.C. and Rauck, R.L. (1989) Cerebral Blood Flow Changes with Caffeine Therapy for Post Dural Headaches. (scirp.org)
- An epidural blood patch is a procedure to treat headaches caused by low pressure in the fluid around the spine and brain. (nshealth.ca)
- Tell her that her sister's epidural had nothing to do with the headaches. (nih.gov)
- There is some evidence of a link between epidurals and headaches although the headaches are treatable with an epidural blood patch. (nih.gov)
Spontaneous Intracranial Hypotension1
- Factors predicting response to the first epidural blood patch in spontaneous intracranial hypotension. (ucdenver.edu)
- Epidural catheter placement was attempted using an 18-gauge Weiss epidural needle inserted perpendicular to the dural fibers at L3-L4 without success. (silverchair.com)
- An epidural blood patch with 15 ml autologous blood injected through an 18-gauge Weiss needle inserted at L3-L4 was performed. (silverchair.com)
- In this case, an epidural blood patch was performed using epidural catheter under fluoroscopic guidance to target the site of CSF leak and to avoid damaging the intrathecal catheter. (scirp.org)
- Your own blood can seal a leak in the spine the same way a bicycle inner tube can be patched. (nshealth.ca)
- This is called a blood patch, because a blood clot can be used to seal the leak. (medlineplus.gov)
- A subanalysis was performed on patients who received epidural blood patches (EBP) to better understand health care utilization attributable to this treatment modality. (nih.gov)
- Thromboelastography-guided Blood Product Transfusion in Cirrhosis Patients with Variceal Bleeding. (kingstongasdocs.uk)
- Glucose sensing is essential for monitoring blood sugar levels in patients with diabetes, but current methods are invasive. (nih.gov)
- When glucose levels become dangerously high or low, the sensor within the lens changes color, alerting patients to potentially harmful blood sugar levels. (nih.gov)
- Glucose-sensing contacts could provide a non-invasive solution for continuous blood sugar monitoring. (nih.gov)
- The patient was monitored during the procedure with non-invasive blood pressure monitoring, pulse oximetry and cardiac monitoring. (biomedcentral.com)
- Axial thin-section CT images obtained through the C1-C2 ( A ) and the C2 ( B ) levels show epidural contrast material accumulation on the left side, with the possible site of leakage at the C1-C2 level. (ajnr.org)
- contrast material injected to confirm the epidural location is identified with mild flattening of the lateral thecal sac margin ( B ). (ajnr.org)
- The trigeminal nerve has three branches that conduct sensations from the scalp, the blood vessels inside and outside of the skull, the lining around the brain (the meninges), and the face, mouth, neck, ears, eyes, and throat. (nih.gov)
- Focused ultrasound uses multiple transducers to produce sound waves that can penetrate the skull and temporarily open the blood-brain barrier (BBB) to allow delivery of siRNA. (nih.gov)
- However, it has recently been proven that applying an electrical field to the dorsal epidural space might activate a larger number of neural structures. (epain.org)
- Sampling of her CSF revealed 74 nucleated cells/μL (76% neutrophils, 20% lymphocytes, 2% monocytes), 64 red blood cells/µL, 84 mg/dL of protein, and 29 mg/dL of glucose (serum glucose 96 mg/dL). (cdc.gov)
- Mrs. Smith tells the clinical nurse, Carol, more about her current pain medications and whether she's open to an epidural while in the pre-operative area. (nih.gov)
- An epidural closed-end, multiorifice, nonstyleted, 19-gauge catheter was inserted 5-6 cm through the Weiss needle and left in place. (silverchair.com)
- Blood loss, uterine tone numerical rating scores, serial venous blood calcium levels, hemodynamics, and potential side effects were also assessed.The study protocol proved feasible. (stanford.edu)
- The epidural catheter was removed immediately after delivery. (silverchair.com)
- Because of persistent fevers, the patient was admitted to an outside hospital 5 days after receiving the third blood patch. (cdc.gov)
- She reported nocturnal fevers, but vital signs, neurologic examination, complete blood counts, and computed tomography of the head were unremarkable. (cdc.gov)
- Focused ultrasound could be used to temporarily open the blood brain barrier to let gene therapy treatments reach the brain. (nih.gov)