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Management of postdural puncture headache with epidural blood patch in children
1Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Finland.
Insights
Epidural blood patch (EBP) provided symptom relief for children experiencing postdural puncture headaches (PDPH) after spinal procedures. This study found EBP to be a safe and effective treatment option for pediatric PDPH.
Area of Science:
- Pediatric Anesthesiology
- Neurology
- Neurosurgery
Background:
- Postdural puncture headache (PDPH) is increasingly recognized in children following spinal procedures.
- Traditional treatments like analgesics, hydration, and bed rest may be insufficient for severe PDPH.
- Epidural blood patch (EBP) is a potential therapeutic option for refractory pediatric PDPH.
Purpose of the Study:
- To evaluate the efficacy and safety of epidural blood patch (EBP) in children experiencing postdural puncture headache (PDPH).
- To analyze the characteristics of PDPH and the outcomes of EBP in a pediatric population.
Main Methods:
- Retrospective analysis of EBP procedures performed in children aged 12 years or younger.
- Data collected from Kuopio University Hospital between 1995 and 2000.
- Inclusion criteria: children who underwent EBP for PDPH or related headaches.
Main Results:
- Seven EBPs were performed in children aged 12 or younger during the 6-year study period.
- Indications for spinal puncture included diagnostic procedures, spinal anesthesia, and hygroma treatment.
- EBP was administered 2-19 days post-spinal puncture, with a mean autologous blood volume of 0.3 ml/kg.
Conclusions:
- Epidural blood patch (EBP) provided symptom relief in all pediatric patients who received the treatment.
- No complications were observed in relation to the epidural blood patch procedures.
- EBP is a safe and effective treatment for postdural puncture headache in children.
Background:
Until the last decade, it was believed that postdural puncture headache (PDPH) was an uncommon complaint in children, but recent studies indicate that young children may develop PDPH after spinal puncture. When the symptoms are severe and are not relieved within a few days with analgesics, forced hydration and bed rest, then epidural blood patch (EBP) might be performed.
Methods:
In this retrospective survey, we analysed EBP performed in Kuopio University Hospital between the years 1995 and 2000.
Results:
During the 6-year period, seven EBP were performed in children aged 12 years or younger. Four out of the seven children had undergone a diagnostic spinal puncture, two had spinal anaesthesia and one child had spinal puncture for treatment of postoperative hygroma. Five children had a typical PDPH, one child had a cerebrospinal fluid fistula headache and one child had a headache similar to his migraine. EBP was performed 2-19 days after spinal puncture with 0.3 ml.kg-1 (mean) of autologous blood injected into the epidural space.
Conclusions:
EBP gave some relief of symptoms in all children. No complications related to EBP were noticed.