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[Epidural blood patch for postdural puncture headache in a five-year-old child]

Junichi Haruna1, Hidenori Yamanaka, Kazuya Tachibana

  • 1Department of Anesthesiology, Aichi Children's Health and Medical Center, Ohbu 474-8710.

Masui. the Japanese Journal of Anesthesiology
|October 22, 2010
PubMed

Insights

A pediatric patient experienced post-dural puncture headache after accidental dural puncture during surgery. An epidural blood patch effectively treated the headache, highlighting its utility in children.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Neurology

Background:

  • Accidental dural puncture can occur during epidural catheter placement in pediatric patients undergoing surgery.
  • Post-dural puncture headache (PDPH) is a potential complication, characterized by positional headache.
  • Conservative management is often attempted but may not always resolve PDPH in children.

Observation:

  • A 5-year-old girl developed severe positional headache 4 days post-orthopedic surgery following an accidental dural puncture during epidural catheterization.
  • Her headache worsened when upright and improved when lying down, consistent with PDPH.
  • Symptoms were refractory to conservative treatments.

Findings:

  • An epidural blood patch (EBP) was successfully performed under general anesthesia.
  • The EBP completely resolved the patient's post-dural puncture headache symptoms.
  • This case underscores the effectiveness of EBP in pediatric PDPH management.

Implications:

  • Epidural blood patch is a viable and effective treatment for post-dural puncture headache in pediatric patients.
  • The incidence of EBP for PDPH in children is reported as low, suggesting potential underutilization.
  • Consideration of epidural blood patch should be part of the management strategy for pediatric PDPH refractory to conservative measures.

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