Here we present a case of PDPH treated with sequential EBPs that resulted in delayed radicular pain. CASE REPORT: A 29-year-old female presented to the emergency room with a severe frontal headache of several days duration. [ncbi.nlm.nih.gov]

• Pseudotumor

  We have discussed potential reasons to perform a lumbar puncture (ex, Headaches, Pseudotumor cerebri, and Mollaret’s Meningitis ). [pedemmorsels.com]

  Pseudotumor cerebri (also called idiopathic intracranial hypertension, or IIH). In this condition,pressure within the subarachnoid space is elevated for reasons that are not clear. [hopkinsmedicine.org]

  […] system malignancies and paraneoplastic syndromes Guillain-Barré syndrome Multiple sclerosis Neuroborreliosis Subarachnoid hemorrhage ( SAH ) Intrathecal administration of pharmaceuticals CSF pressure measurement Idiopathic intracranial hypertension ( pseudotumor [amboss.com]

  My neurologist wanted to test me for Pseudotumor Cerebri as possibly being the cause of my headaches. I haven't heard the results yet. [mdjunction.com]

  Just wish that work could see and feel what the pain is actually like after My son (15) has pseudotumor cerebri which is in remission. 6 days ago he was complaining of headache behind his eyes and blurred vision. [medhelp.org]

• Sepsis

  Her evaluation included consultation with neurologists, hematologic testing for evidence of sepsis, and magnetic resonance imaging of the brain to rule out mass lesion or cortical vein thrombosis. [anesthesiology.pubs.asahq.org]

  […] recurrent nerve paralysis反回神経麻痺 regional anesthesia区域麻酔、局所麻酔 respiratory minute volume分時換気量 resuscitation蘇生[法] retrograde amnesia逆行[性]健忘 rigidity強直、硬直 root block神経根ブロック root pain神経根痛、根性痛 s saturation飽和、飽和度 sedation 鎮静 sedative 鎮静薬、鎮静の semiclosed method半閉鎖法 sepsis [tokyo-med.ac.jp]

  […] symptoms; 9) active neurological disease; and 10) generalized sepsis. [intechopen.com]

• Asymptomatic

  She was discharged the following day asymptomatic and remained asymptomatic at 3 days and 1 week later. Discussion The typical PDPH is frontal–occipital and may radiate to the neck or shoulders. [anesthesiology.pubs.asahq.org]

  She has remained asymptomatic since then and has been receiving treatment with interferon-beta for multiple sclerosis. [ajnr.org]

• Chills

  I also had a spinal tap done by ER doctor on 2/17/16 to test for meningitis cause I had a fever of 102, chills and it felt like my head was about to explode! [medhelp.org]

• Crying

  I lay each time crying. Cause no one has found out what to do. I had CT scans. Blood drawns, pelvic exam, and everything is negative. Im trying all options. [medhelp.org]

• Muscle Rigidity

  […] relaxant 筋弛緩薬 muscle rigidity筋硬直 mydriasis散瞳 n narcotic麻薬、麻薬の nasal cannula鼻カニューレ nasogastric tube (NG tube)胃管、経鼻胃管 nasotracheal intubation経鼻挿管 nausea悪心、嘔気 necrosis壊死 nerve block 神経ブロック nerve block anesthesia 神経ブロック麻酔[法] nerve plexus blockade 神経叢ブロック [tokyo-med.ac.jp]

• Abdominal Pain

  Headaches, abdominal pain, etc. Went to see my primary Dr. He told me there is no way all is related to the procedure. That I'm not trying to manage the day. I've had severe pain n my right leg. Could barely walk. [medhelp.org]

• Hypertension

  It appears that CSF volume is decreased in the presence of systemic hypertension however it is still unclear if the CSF pressure in systemic hypertension is decreased as well. [eurekaselect.com]

  We report a unique case of a spontaneous frontal epidural hematoma following a therapeutic lumbar puncture in a patient with a history of idiopathic intracranial hypertension. [ncbi.nlm.nih.gov]

  Hyperperfusion encephalopathies: hypertensive encephalopathy and related conditions. Neurologist 2002 ; 8 : 22 –34 ↵ Gobel H, Klostermann H, Lindner V, et al. [ajnr.org]

  In addition, drainage of CSF can lead to symptomatic improvement in patients with idiopathic intracranial hypertension and normal pressure hydrocephalus. [amboss.com]

  […] cerebral hemorrhage, cerebral infarction, preeclampsia, migraine headache, and cortical vein thrombosis. 4,5 Although preeclampsia and meningitis are included in the differential diagnosis of PDPH, these possibilities were unlikely because of the lack of hypertension [anesthesiology.pubs.asahq.org]

• Thrombosis

  Because of the patient’s complaint of increasing severity of the headache in the supine position and lack of response to epidural blood patch, cortical vein thrombosis was again considered. [anesthesiology.pubs.asahq.org]

  Venous sinus thrombosis. Subdural haematoma. MRI findings Crowding and caudal displacement (“sagging”) of the posterior fossa structures of the brain. Diffuse pachymeningeal enhancement. Engorgement of the epidural venous plexuses. [emed.ie]

  Mouraux A, Gille M, Dorban S, Peeters A: Cortical venous thrombosis after lumbar puncture. J Neurol 2002;249:1313–1315. [karger.com]

  […] venous thrombosis, intracranial subdural hematoma, benign intracranial hypertension, migrane and caffeine withdrawal headache should also be considered 10. [apicareonline.com]

  Differential diagnosis Venous sinus thrombosis Rare. Headache and seizures Migraine Subarachnoid bleed Intracranial haematoma Caffeine withdrawal etc 15. [slideshare.net]

• Spontaneous Rupture of Membranes

  Case Report A healthy 19-yr-old term parturient (gravida II, para 0) was admitted to the hospital in active labor after spontaneous rupture of membranes. She requested epidural analgesia. [anesthesiology.pubs.asahq.org]

• Photophobia

  […] pediatrics is similar – 25% [ Leblanc, 2005 ] Diagnostic Criteria Headache that increases w/in 15 min of standing, improves w/in 15 min of lying down, and has ONE of the following AND also fulfills the remaining criteria: Neck stiffness Tinnitus Hyperacusis Photophobia [pedemmorsels.com]

  […] following criteria ( IHS 2004 ): Occurs after dural puncture, Develops within 5 days of LP, Worsens within 15 minutes after sitting or standing and improves within 15 min after lying down and is associated with either neck stiffness, tinnitus, hypoacusia, photophobia [coreem.net]

  She denied vomiting, photophobia, tinnitus, or symptoms of cranial nerve involvement. Physical examination and vital signs were within normal limits. A diagnosis of PDPH was made. [anesthesiology.pubs.asahq.org]

  On 80% of patients with PDPH either of neck stiffness, nausea, or photophobia was observed ( Figure 4 ). Figure 3: Severity of headache among patients who developed PDPH in GUH from February 25-April 10, 2013. [omicsonline.org]

  On the third day, she experienced severe postural headaches (not associated with neck rigidity, photophobia, nausea, or emesis), and a PDPH was diagnosed. [ajnr.org]

• Blurred Vision

  Visual changes (photophobia, diplopia, blurred vision) and auditory changes (hyperacusis, vertigo, tinnitus, ataxia, hearing loss) are not uncommon 8. [apicareonline.com]

  Just wish that work could see and feel what the pain is actually like after My son (15) has pseudotumor cerebri which is in remission. 6 days ago he was complaining of headache behind his eyes and blurred vision. [medhelp.org]

• Visual Impairment

  When the headache is not postural, accompanied by cranial nerve effects, stiff neck, fever or visual impairment, it is important to exclude other conditions. [tidsskriftet.no]

• Tinnitus

  Tinnitus is probably due to a cochlear dysfunction, and presents special characteristics. [ncbi.nlm.nih.gov]

  Post Lumbar Puncture Headache Caffeine Taurate Magnesium Tinnitus the long-term course of migraine with aura (MA) has been poorly explored. [emergingindustries.eu]

• Fear

  CONCLUSIONS: Fear of the procedure does not predispose to occurrence of post-LP headache while a history of headache and elevated intracranial pressure does. [ncbi.nlm.nih.gov]

  Knowing what to expect relieves some of the fear. Have someone drive you to your appointment so you don’t have to drive home. Even if you’re not in pain, you may feel woozy or “off” from nervousness. [thedailyheadache.com]

  […] precisely understand: 1) PDPH is a self-terminating process; 2) many medical procedures can alleviate and treat PDPH; 3) active cooperation with clinicians will promote resolution; 4) keep normal diet; and 5) think solutions with faith but not with fear [intechopen.com]

• Headache

  Certain factors contribute to the development of headache after lumbar puncture. If these factors are taken into consideration, the incidence of headache could be markedly reduced. [ncbi.nlm.nih.gov]

• Meningism

  CONCLUSION: PLPH is related to increased Gd-DTPA enhancement of the meninges, although the increase in enhancement during PLPH is minor in most cases. Pronounced enhancement of the meninges after lumbar puncture may predict long duration of the PLPH. [ncbi.nlm.nih.gov]

  It is enterovirus season – and with that comes viral (aseptic) meningitis. Now you may argue (correctly) that you don’t need to do an LP if your pre-test probability for bacterial meningitis is low. [pemcincinnati.com]

• Neuralgia

  ) trigeminal neuralgia ( G50.0 ) Complication (s) (from) (of) lumbar puncture G97.1 headache or reaction G97.1 postoperative - see Complications, postprocedural lumbar puncture G97.1 puncture, spinal G97.1 headache or reaction G97.1 spinal puncture [icd10data.com]

  […] muscle rigidity筋硬直 mydriasis散瞳 n narcotic麻薬、麻薬の nasal cannula鼻カニューレ nasogastric tube (NG tube)胃管、経鼻胃管 nasotracheal intubation経鼻挿管 nausea悪心、嘔気 necrosis壊死 nerve block 神経ブロック nerve block anesthesia 神経ブロック麻酔[法] nerve plexus blockade 神経叢ブロック nerve root神経根 neuralgia [tokyo-med.ac.jp]

  Illness Forums > Multiple Sclerosis ✚ New Topic 1 2 3 4 5 ... 154 155 Odd symptoms ms By Jesuslovesus27 2 replies 59 views Jesuslovesus27 5/11/2019 11:26 AM Secondary Progressive MS By PatMc 2 replies 471 views Gretchen1 4/24/2019 8:57 PM Trigeminal Neuralgia [healingwell.com]

  Well my eye doctor also ordered an MRI with contrast and he also had them to check my orbits (I have glaucoma too) I worked in pain management for 6 years and I remembered that some patients came in for Occipital neuralgia, I looked up the cause and symptoms [medhelp.org]

• Paresthesia

  Other symptoms that may be associated with PLPH include nausea, vomiting, hearing loss, tinnitus, vertigo, dizziness, diplopia, cranial nerve palsies and paresthesia of the scalp, and upper or lower limb pain. [karger.com]

  We observed no significant difference in the risk of paresthesia, backache, severe PDPH and any headache between traumatic and atraumatic needles. [spinalcsfleak.org]

  […] orientation見当識 orientation disturbance見当識障害 outcome転帰、予後 outpatient外来患者 overdosage過量、過量投与 oxygen cascade酸素瀑布、酸素カスケード oxygen consumption (VO2)酸素消費量 oxygen delivery酸素輸送 oxygen demand酸素需要 oxygen dissociation curve (ODC)酸素解離曲線 p palsy不全麻痺、軽症麻痺 paralysis完全麻痺、重症麻痺 paresthesia [tokyo-med.ac.jp]

  Symptoms potentially associated with PLPH are nausea, vomiting, hearing loss and tinnitus, vertigo, diplopia, dizziness, limb pain, cranial nerve palsies, and paresthesia of the scalp (Lavi et al., 2010). [thefreelibrary.com]

• Tremor

  Post dural puncture headache treatment options Drugs Caffeine: cerebral vasoconstriction Dose: 300-500mg bd or qid (coffee=50-100mg) However temporary effect only, side-effects: agitation, tremor, insomnia Survey in CJA 1998: most practitioners abandoned [slideshare.net]

  […] thermometer温度計 threshold閾値、限界値 tidal volume (TV, VT)1回換気量 topical anesthesia 表面麻酔[法] tourniquet駆血帯、ターニケット toxic dose中毒量 tracheal cuff気管カフ tracheal intubation気管挿管 tracheostomy気管開口[術]、気管切開 [術] transesophageal echocardiography (TEE)経食道心エコー法 transfusion輸血 tremor [tokyo-med.ac.jp]

PDPH 24 hours after treatment, classified on a 4-point scale (no, mild, moderate, severe) is the primary outcome. The secondary outcome is the presence of PDPH 7 days after treatment. [ncbi.nlm.nih.gov]

Treatment with EDBP is not an option during the study period of 7 days, not even when conservative treatment fails. Outcomes The primary outcome is whether or not headache is present at 24 hours after the start of treatment. [bmcneurol.biomedcentral.com]

However, because the treatment of PDPH with cosyntropin is noninvasive and may be beneficial, we believe it should be considered in the treatment of PDPH. [anesthesiology.pubs.asahq.org]

In this setting, a trigger factor, such as an increase in systemic blood pressure, generates segmental vasogenic edema. 2, 4 Despite the good overall prognosis, this condition is not completely benign because of the potential for bleeding into the lesion [ajnr.org]

Part II: prevention, management, and prognosis. Headache 50:1482–1498 PubMed CrossRef Google Scholar 4. Ahmed SV, Jayawarna C, Jude E (2006) Post lumbar puncture headache: diagnosis and management. [link.springer.com]

© Nordland Hospital Bodø Treatment and prognosis Post-dural puncture headache has in principle a self-limiting course. [tidsskriftet.no]

Bezov D, Ashina S, Lipton R (2010) Post-dural puncture headache: Part II--prevention, management, and prognosis. Headache 50: 1482-1498. [omicsonline.org]

Two case reports are presented, followed by a review of the literature concerning etiology, diagnosis, and treatment of post-lumbar puncture headache. [ncbi.nlm.nih.gov]

Post-lumbar puncture headache: etiology and management. West J Med 1998 ; 148 : 551 -4. Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003 ; 91 : 718 -29. Sudlow C, Warlow C. [emed.ie]

Post-dural puncture headache: Part I diagnosis, epidemiology, etiology and pathophysiology. Headache. 2010;50:1144-1152. PMID: 20533959 Hammond ER et al. Needle type and the risk of post-lumbar puncture headache in the outpatient neurology clinic. [coreem.net]

Etiology and management. West J Med 1988;148(5):551-4. Casey WF. Post lumbar puncture headache. J R Soc Med 1982;75(9):752-3. Sharma R, Bailey A, Bamber J. Post-dural puncture headache. Br J Anaesth 2004;92(3):449-50. Lin W, Geiderman J. [acta.tums.ac.ir]

[…] and management (National Center for Biotechnology Information) Cerebrospinal fluid (CSF) (Encyclopædia Britannica) Spinal headaches (Mayo Clinic) Lumbar puncture (spinal tap) (Mayo Clinic) Post-dural puncture headache: part I diagnosis, epidemiology, etiology [headacheandmigrainenews.com]

Post-dural puncture headache: Part I diagnosis, epidemiology, etiology and pathophysiology. Headache. 2010;50:1144-1152. PMID: 20533959 Hammond ER et al. Needle type and the risk of post-lumbar puncture headache in the outpatient neurology clinic. [coreem.net]

diagnosis and management (National Center for Biotechnology Information) Cerebrospinal fluid (CSF) (Encyclopædia Britannica) Spinal headaches (Mayo Clinic) Lumbar puncture (spinal tap) (Mayo Clinic) Post-dural puncture headache: part I diagnosis, epidemiology [headacheandmigrainenews.com]

History and epidemiology First epidural blockade was reported by an American physician Dr. James Leonard Corning in 1885 [ 26 ]. The actual history of spinal anesthesia can be traced back to 1888 by German physician Dr. [intechopen.com]

This article outlines the pathophysiology and incidence of headaches related to lumbar punctures in the pediatric oncology setting and reviews the evidence from research trials to suggest which interventions clinicians should adopt into their practice [ncbi.nlm.nih.gov]

The pathophysiology leading to headache is thought to be persistent leakage of cerebral spinal fluid (CSF) from the puncture site causing low CSF pressure and volume ( Bezov 2010 ). [coreem.net]

In terms of the prevention and treatment of post-LP headaches, both are equally important in management. Following, is a discussion of which techniques and preventative measures are evidence based and which are not. [foamem.com]

This narrative review explores the literature to determine strategies for preventing headache and provide evidence-based nursing care to adults with post-lumbar puncture headache. [ncbi.nlm.nih.gov]