Postpartum Headache—Unmasking the Zebra Among the Horses: A Case Report
Postdural puncture headache (PDPH) is a complication of dural puncture. An epidural blood patch (EBP) is the standard treatment; however, when EBP fails, alternative treatments and/or diagnoses must be considered. We present a case of orthostatic headache initially diagnosed as PDPH but likely due t...
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| Published in: | A&A practice Vol. 14; no. 13; p. e01340 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Lippincott Williams & Wilkins
06-11-2020
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| Abstract | Postdural puncture headache (PDPH) is a complication of dural puncture. An epidural blood patch (EBP) is the standard treatment; however, when EBP fails, alternative treatments and/or diagnoses must be considered. We present a case of orthostatic headache initially diagnosed as PDPH but likely due to spontaneous intracranial hypotension. It is imperative for anesthesiologists, as members of an interdisciplinary peripartum team, to be familiar with the evaluation and treatment of postpartum headache and recognize when further workup and consultation may be indicated. |
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| AbstractList | Postdural puncture headache (PDPH) is a complication of dural puncture. An epidural blood patch (EBP) is the standard treatment; however, when EBP fails, alternative treatments and/or diagnoses must be considered. We present a case of orthostatic headache initially diagnosed as PDPH but likely due to spontaneous intracranial hypotension. It is imperative for anesthesiologists, as members of an interdisciplinary peripartum team, to be familiar with the evaluation and treatment of postpartum headache and recognize when further workup and consultation may be indicated. |
| Author | Euliano, Tammy Cometa, M. Anthony Jones, Anastasia Lopez, Brandon M. |
| AuthorAffiliation | From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida |
| AuthorAffiliation_xml | – name: From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida |
| Author_xml | – sequence: 1 givenname: Anastasia surname: Jones fullname: Jones, Anastasia organization: From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida – sequence: 2 givenname: M. Anthony surname: Cometa fullname: Cometa, M. Anthony – sequence: 3 givenname: Tammy surname: Euliano fullname: Euliano, Tammy – sequence: 4 givenname: Brandon M. surname: Lopez fullname: Lopez, Brandon M. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33185404$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/BF03021057 10.1001/jama.295.19.2286 10.1111/head.13095 10.1177/0333102417738202 10.1159/000206856 10.1097/ALN.0000000000002322 10.1007/s10072-009-0060-8 10.1016/S1474-4422(12)70306-X 10.1007/s13760-019-01166-8 10.3171/foc.2003.15.6.8 10.1111/head.13328 10.1136/rapm-2018-000021 |
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| References | Mea (R6-20231110) 2009; 30 Kranz (R10-20231110) 2018; 58 (R8-20231110) 2018; 38 Choi (R2-20231110) 2003; 50 Ferrante (R4-20231110) 2020; 120 Pagani-Estévez (R11-20231110) 2019; 44 Edlow (R3-20231110) 2013; 12 Paldino (R7-20231110) 2003; 15 Su (R9-20231110) 2009; 61 Niraj (R12-20231110) 2017; 57 Schievink (R5-20231110) 2006; 295 Butwick (R1-20231110) 2018; 129 |
| References_xml | – volume: 50 start-page: 460 year: 2003 ident: R2-20231110 article-title: PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. publication-title: Can J Anaesth doi: 10.1007/BF03021057 contributor: fullname: Choi – volume: 295 start-page: 2286 year: 2006 ident: R5-20231110 article-title: Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. publication-title: JAMA doi: 10.1001/jama.295.19.2286 contributor: fullname: Schievink – volume: 57 start-page: 952 year: 2017 ident: R12-20231110 article-title: Greater occipital nerve treatment in the management of spontaneous intracranial hypotension headache: a case report. publication-title: Headache doi: 10.1111/head.13095 contributor: fullname: Niraj – volume: 38 start-page: 1 year: 2018 ident: R8-20231110 article-title: The International Classification of Headache Disorders, 3rd edition. publication-title: Cephalalgia doi: 10.1177/0333102417738202 – volume: 61 start-page: 301 year: 2009 ident: R9-20231110 article-title: Clinical features, neuroimaging and treatment of spontaneous intracranial hypotension and magnetic resonance imaging evidence of blind epidural blood patch. publication-title: Eur Neurol doi: 10.1159/000206856 contributor: fullname: Su – volume: 129 start-page: 448 year: 2018 ident: R1-20231110 article-title: Maternal body mass index and use of labor neuraxial analgesia: a population-based retrospective cohort study. publication-title: Anesthesiology doi: 10.1097/ALN.0000000000002322 contributor: fullname: Butwick – volume: 30 start-page: S11 issue: suppl 1 year: 2009 ident: R6-20231110 article-title: Clinical features and outcomes in spontaneous intracranial hypotension: a survey of 90 consecutive patients. publication-title: Neurol Sci doi: 10.1007/s10072-009-0060-8 contributor: fullname: Mea – volume: 12 start-page: 175 year: 2013 ident: R3-20231110 article-title: Diagnosis of acute neurological emergencies in pregnant and post-partum women. publication-title: Lancet Neurol doi: 10.1016/S1474-4422(12)70306-X contributor: fullname: Edlow – volume: 120 start-page: 9 year: 2020 ident: R4-20231110 article-title: Spontaneous intracranial hypotension: review and expert opinion. publication-title: Acta Neurol Belg doi: 10.1007/s13760-019-01166-8 contributor: fullname: Ferrante – volume: 15 start-page: ECP2 year: 2003 ident: R7-20231110 article-title: Intracranial hypotension syndrome: a comprehensive review. publication-title: Neurosurg Focus doi: 10.3171/foc.2003.15.6.8 contributor: fullname: Paldino – volume: 58 start-page: 948 year: 2018 ident: R10-20231110 article-title: Spontaneous intracranial hypotension: 10 myths and misperceptions. publication-title: Headache doi: 10.1111/head.13328 contributor: fullname: Kranz – volume: 44 start-page: 212 year: 2019 ident: R11-20231110 article-title: Procedural predictors of epidural blood patch efficacy in spontaneous intracranial hypotension. publication-title: Reg Anesth Pain Med doi: 10.1136/rapm-2018-000021 contributor: fullname: Pagani-Estévez |
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| SubjectTerms | Blood Patch, Epidural Female Headache - etiology Headache - therapy Humans Post-Dural Puncture Headache - etiology Post-Dural Puncture Headache - therapy Postpartum Period |
| Title | Postpartum Headache—Unmasking the Zebra Among the Horses: A Case Report |
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