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A causative role for remote dural puncture and resultant arachnoid bleb in new daily persistent headache: A case report.
Callen, Andrew L; Lennarson, Peter; Carroll, Ian R.
Afiliación
  • Callen AL; Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Lennarson P; Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Carroll IR; Department of Anesthesia, Stanford University, Palo Alto, California, USA.
Headache ; 63(7): 981-983, 2023.
Article en En | MEDLINE | ID: mdl-37358488
ABSTRACT
A 24-year-old woman experienced a postdural puncture headache following a labor epidural, recovered following bedrest, and was then without headache for 12 years. She then experienced sudden onset of daily, holocephalic headache persisting for 6 years prior to presentation. Pain reduced with prolonged recumbency. MRI brain, MRI myelography, and later bilateral decubitus digital subtraction myelography showed no cerebrospinal fluid (CSF) leak or CSF venous fistula, and normal opening pressure. Review of an initial noncontrast MRI myelogram revealed a subcentimeter dural outpouching at L3-L4, suspicious for a posttraumatic arachnoid bleb. Targeted epidural fibrin patch at the bleb resulted in profound but temporary symptom relief, and the patient was offered surgical repair. Intraoperatively, an arachnoid bleb was discovered and repaired followed by remission of headache. We report that a distant dural puncture can play a causative role in the long delayed onset of new daily persistent headache.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parche de Sangre Epidural / Cefalea Pospunción de la Duramadre Tipo de estudio: Etiology_studies Límite: Adult / Female / Humans Idioma: En Revista: Headache Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parche de Sangre Epidural / Cefalea Pospunción de la Duramadre Tipo de estudio: Etiology_studies Límite: Adult / Female / Humans Idioma: En Revista: Headache Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
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