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Accessing the Subdural Space of the Rodent Spinal Cord for Treatment Delivery
Published on: August 8, 2025
[Epidural patch with dextran 40 to prevent postdural puncture headache in an HIV patient: case report.]
Marcos Guilherme Cunha Cruvinel1, Paulo Roberto Vieira Barbosa, Vera Coelho Teixeira
1CET, SBA, Hospital Felício Rocho.
Revista Brasileira De Anestesiologia
|May 29, 2009
Summary
This case study explores using dextran 40 epidural injections to prevent postdural puncture headache in an HIV-positive patient. The treatment proved effective, preventing headache after spinal anesthesia.
Area of Science:
- Anesthesiology
- Neurology
Context:
- Postdural puncture headache (PDPH) is a common complication of neuraxial anesthesia.
- The epidural blood patch is the gold standard treatment but is invasive and has contraindications.
- Alternative prophylactic methods are needed, especially for high-risk populations like HIV-positive patients.
Purpose:
- To report a case of prophylactic epidural dextran 40 administration in an HIV-positive patient with a history of PDPH.
- To evaluate the efficacy of epidural dextran 40 as a preventative measure against PDPH.
Summary:
- A 31-year-old HIV-positive male with a history of PDPH underwent spinal anesthesia.
- An accidental dural puncture occurred during an epidural attempt.
- Two doses of epidural dextran 40 were administered prophylactically, resulting in no PDPH and successful discharge.
Impact:
- This case suggests epidural dextran 40 may be a viable prophylactic option for PDPH in specific patient groups.
- Further investigation into colloid solutions like dextran 40 for PDPH prevention is warranted.
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