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Post dural puncture headache in a pediatric patient with idiopathic intracranial hypertension

Olubukola O Nafiu1, Dominic Monterosso, Sarah R Walton

  • 1Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109-0048, USA. onafiu@med.umich.edu

Paediatric Anaesthesia
|August 17, 2005
PubMed

Insights

Postdural puncture headache (PPDH) is rare in adolescents with idiopathic intracranial hypertension (IIH). An epidural blood patch effectively treated PPDH in a pediatric patient with IIH, resolving symptoms and improving vision.

Area of Science:

  • Neurology
  • Pediatrics
  • Neurosurgery

Background:

  • Idiopathic intracranial hypertension (IIH) presents a paradoxical scenario for postdural puncture headache (PPDH).
  • PPDH is exceptionally uncommon in patients with elevated intracranial pressure.
  • Limited adult case reports exist on the association between IIH and PPDH.

Observation:

  • A 15-year-old female diagnosed with IIH developed PPDH 24 hours after an uncomplicated diagnostic spinal tap.
  • Initial conservative management for PPDH was unsuccessful in this adolescent patient.

Findings:

  • An epidural blood patch using 15 ml of autologous venous blood provided immediate and complete resolution of PPDH.
  • The patient experienced significant improvement in visual field defects and papilledema following the procedure.

Implications:

  • This case represents the first documented instance of PPDH in a pediatric patient with IIH and its successful management with an epidural blood patch.
  • The findings suggest that epidural blood patching is a safe and effective treatment for PPDH in pediatric IIH patients, even in paradoxical presentations.

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