Successful treatment of a recurrent post-dural puncture headache with an epidural blood patch 18 months after the initial dural puncture. (November 2019)

• Record Type: Journal Article
• Authors: Spring, A.; McMorrow, R.
• Is Part Of: International journal of obstetric anesthesia. Volume 40(2019)
• Page Start: 152
• Page End: 153
• Publication Date: 2019-11
• Subjects: Headache -- Post-dural puncture -- Epidural blood patch; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2019.04.009
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: Post-dural puncture headache (PDPH) is incapacitating for the mother with a newborn. Epidural blood patch is an established treatment in those presenting acutely. In those with delayed or recurrent presentations, treatment strategy is less clear. We successfully treated a very late recurrent PDPH with an epidural blood patch. Abstract: Inadvertent dural puncture is a recognised complication of epidural insertion. Parturients are at increased risk of developing a post-dural puncture headache, which can be debilitating for a mother caring for a newborn infant. Epidural blood patch is an effective treatment in patients presenting acutely with post-dural puncture headaches but its efficacy in those with delayed presentation or with late recurrent post-dural puncture headache is less clear. We present the case of a woman with a recurrent post-dural puncture headache who was successfully treated with an epidural blood patch 18 months after the initial dural puncture. Patients who develop post-dural puncture headaches may remain symptomatic for some time and an epidural blood patch may be beneficial, following appropriate investigation.