Korean J Anesthesiol.  2007 Feb;52(2):245-248. 10.4097/kjae.2007.52.2.245.

Spontaneous Intracranial Hypotension after Post-dural Puncture Headache : A case report

• Kim DK
• Son JS
• Kim DC
• Lee JW
• Lim HS

• KMID: 2236632
• DOI: http://doi.org/10.4097/kjae.2007.52.2.245

Abstract

Spontaneous intracranial hypotension (SIH) occurs without any preceding events such as lumbar puncture, surgery, trauma, or medical illness. It is characterized by a postural headache that is aggravated whilst in the erect or sitting position, and is relieved in the supine position. A postural headache usually resolves either spontaneously or with conservative treatment. An epidural block is a very important treatment for lumbago and is mostly performed for pain control. However, an incidental dural puncture is possible during epidural block and anesthesiology and pain medicine doctor should be familiar with an epidural block. Radioisotope cisternography is a highly sensitive, reliable and safe technique for confirming of the presence and location of cerebrospinal fluid (CSF) leakage. We report two cases of spontaneous intracranial hypotension that was diagnosed by SIH through cisternography in a situation where the post-dural puncture headache was primarily suspected as being the cause. If a postural headache occurs after an epidural block through an epidural needle without CSF leakage, other causes e.g. dural puncture need to be identified.

Keyword

cisternography; spontaneous intracranial headache; post-dural puncture headache

MeSH Terms

Anesthesiology
Cerebrospinal Fluid
Headache
Intracranial Hypotension*
Low Back Pain
Needles
Post-Dural Puncture Headache*
Punctures
Spinal Puncture
Supine Position