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Epidural blood patch for headache after lumboperitoneal shunt placement
Leonard R Allmond1, Greg Stratmann, Sandeep M Kunwar
1Department of *Anesthesia and Perioperative Care and †Neurological Surgery, The University of California at San Francisco.
Anesthesia and Analgesia
|October 26, 2005
Summary
Low-pressure headaches after lumboperitoneal (LP) shunt placement may stem from postdural puncture. An epidural blood patch effectively treated a patient, suggesting it as an alternative initial therapy for such headaches.
Area of Science:
- Neurosurgery
- Neurology
- Anesthesiology
Background:
- Lumboperitoneal (LP) shunts are used to manage cerebrospinal fluid disorders.
- Headaches post-LP shunt placement are typically linked to high or low intracranial pressure due to shunt malfunction or overdrainage.
Observation:
- A 17-year-old female experienced low-pressure headaches following LP shunt placement.
- Her symptoms significantly improved after receiving an epidural blood patch.
Findings:
- The successful treatment with an epidural blood patch suggests postdural puncture as a potential cause of low-pressure headaches after LP shunt procedures.
- This indicates that the headache might be a complication of the dural puncture during shunt insertion rather than solely shunt-related pressure issues.
Implications:
- Epidural blood patch therapy could be considered as an initial treatment option for select cases of low-pressure headaches post-LP shunt placement.
- This finding may alter the diagnostic and therapeutic approach to headaches following cerebrospinal fluid shunting procedures.