Cerebrospinal Fluid Leak After Disconnection of an Intrathecal Catheter Adapter Placed After Accidental Dural Puncture

2005 ◽  
Vol 30 (6) ◽  
pp. 591 ◽  
Author(s):  
Shaul Cohen ◽  
Paul Stricker ◽  
Ashraf Sakr
2014 ◽  
Vol 58 (6) ◽  
pp. 771
Author(s):  
Ashish Bangaari ◽  
MirzaAnwar Ahmed Baig ◽  
Munisamy Ragavan ◽  
RajanRajendra Kumar

2013 ◽  
Vol 11 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Wouter I. Schievink ◽  
M. Marcel Maya

Headache occurs after dural puncture in about 1%–25% of children who undergo the procedure—a rate similar to that seen in adults. Persistence of post–dural puncture headache in spite of bed rest, increased fluid intake, and epidural blood patch treatment, however, is rare. The authors reviewed the medical records and imaging studies of all patients 19 years of age or younger who they evaluated between 2001 and 2010 for intracranial hypotension, and they identified 8 children who had persistent post–dural puncture headache despite maximal medical treatment and placement of epidural blood patches. A CSF leak could be demonstrated radiologically and treated surgically in 3 of these patients, and the authors report these 3 cases. The patients were 2 girls (ages 14 and 16 years) who had undergone lumbar puncture for evaluation of headache and fever and 1 boy (age 13 years) who had undergone placement of a lumboperitoneal shunt using a Tuohy needle for treatment of pseudotumor cerebri. The boy also had undergone a laminectomy and exploration of the posterior dural sac, but no CSF leak could be identified. All 3 patients presented with new-onset orthostatic headaches, and in all 3 cases MRI demonstrated a large ventral lumbar or thoracolumbar CSF collection. Conventional myelography or digital subtraction myelography revealed a ventral dural defect at L2–3 requiring surgical repair. Through a posterior transdural approach, the dural defect was repaired using 6-0 Prolene sutures and a dural substitute. Postoperative recovery was uneventful, with complete resolution of orthostatic headache and of the ventral cerebrospinal fluid leak on MRI. The authors conclude that persistent postdural puncture headache requiring surgical repair is rare in children. They note that the CSF leak may be located ventrally and may require conventional or digital subtraction myelography for exact localization and that transdural repair is safe and effective in eliminating the headaches.


Cureus ◽  
2020 ◽  
Author(s):  
Stephanie A Armstrong ◽  
Huy Tram N Nguyen ◽  
Susan L Rebsamen ◽  
Bermans Iskandar ◽  
James A Stadler

2019 ◽  
Vol 14 (3) ◽  
pp. 44-47
Author(s):  
Anna Whalen-Browne ◽  
Kristyne Onizuka ◽  
Maria Tiboni ◽  
Ragini Srinivasan

ABSTRACTHeadaches in the post-partum period are common, while new seizures are not. While many causes of post-partum headache are benign, it can be difficult to determine which patients warrant a more comprehensive workup to investigate for serious causes, which may only present later with neurologic sequelae such as new seizures. We suggest that persistent post-dural puncture headaches in the context of intrapartum epidural anesthesia can be suggestive of a serious cause such as intracranial hypotension or subdural hematoma. We describe a case of a 28-year-old G1P1 female presenting with a first-time seizure at 19 days post-partum caused by subdural hematoma from a persistent cerebrospinal fluid leak. This was in the context of a history of typical post-dural puncture headache following delivery. RÉSUMÉLes maux de tête dans la période post-partum sont fréquents, alors que les nouvelles crises ne le sont pas. Bien que de nombreuses causes de céphalées post-partum soient bénignes, il peut être difficile de déterminer quels patients justifient un bilan plus complet pour rechercher les causes graves, qui peuvent ne se présenter que plus tard avec des séquelles neurologiques comme de nouvelles crises. Nous suggérons que les maux de tête persistants post-ponctionnels dans le contexte de l’anesthésie épidurale intra-partum peuvent suggérer une cause grave comme l’hypotension intracrânienne ou un hématome sous-dural. Nous décrivons le cas d’une femme G1P1 de 28 ans qui présente une première crise d’épilepsie 19 jours après l’accouchement causée par un hématome sous-dural causé par une fuite persistante de liquide céphalorachidien. C’était dans le contexte d’une histoire de céphalées typiques après une ponction post-durale après l’accouchement.


2012 ◽  
Vol 108 (3) ◽  
pp. 529-530 ◽  
Author(s):  
V. Loures ◽  
G.L. Savoldelli ◽  
C. Alberque ◽  
G. Haller

Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
E. Pasquini ◽  
G. Tenti ◽  
C. Bordonaro ◽  
P. Farneti ◽  
V. Sciarretta ◽  
...  

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