Related Experiment Video
Updated: Jul 19, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Intractable post dural puncture headache in a patient with undiagnosed intrathoracic meningocele
Dr Reena1, Subash Sankaralingam1, Swati Singh2
1Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Abstract:
Post dural puncture headache (PDPH) is a troublesome complication of dural puncture. Although its risk factors and management have been extensively discussed in the literature, the underlying cause may sometimes remain unclear, making treatment challenging for anaesthesiologists. We describe a noteworthy case of PDPH following spinal anaesthesia administered for an emergency cesarean section in a patient with known neurofibromatosis. Despite conservative and pharmacological treatment, followed by an autologous epidural blood patch, no symptomatic relief was achieved. Neuroimaging of the brain and spine revealed a large intrathoracic meningocele (IM). Although rare, intrathoracic meningocele should be considered in patients with neurofibromatosis who develop intractable PDPH after dural puncture, with neuroimaging being the most effective diagnostic tool.
Related Concept Videos
Cranial and Spinal Meninges
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Bacterial Meningitis I: Introduction
Bacterial Meningitis II: Pathophysiology
Brain Abscess l: Introduction
Increased Intracranial Pressure l: Introduction
Increased Intracranial Pressure ll: Pathophysiology

