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Post-dural puncture headache accompanied by obvious nasal congestion: A case report
Ming Yan1, Qiao Wang, Yufeng Zhang
1Department of Anesthesiology, The Huai'an Maternity and Child Clinical College of Xuzhou Medical University (Huai' an maternal and child health care center), Huaian, China.
Introduction:
Post-dural puncture headache (PDPH) is the most common complication of intraspinal nerve block in gravida. PDPH may be accompanied by neck stiffness, tinnitus, hearing loss, photophobia or nausea.
Patient Concerns:
A 33-year-old woman whose dura was accidentally punctured during labor analgesia complained of severe headache, dizziness, and nasal congestion; these symptoms aggravated when she looked up, and her sense of smell was normal 8 hours after catheter removal.
Diagnoses:
Based on the patient's complaints and clinical appearance, diagnosis of PDPH was considered.
Interventions:
Nasal congestion disappeared with headache and dizziness after epidural injections of saline. The puerpera received saline injections 4 times; after treatment, she was discharged from the hospital when the symptoms did not limit her daily movement.
Outcomes:
The symptoms disappeared completely on the seventh day of telephone follow-up visit. The mechanism of her nasal obstruction is not very clear.
Conclusion:
We believe it is caused by the pulling of the intracranial nerve as the brain tissue sinks and shifts due to the decrease in intracranial pressure.
