Postdural Puncture Headache, Subdural Hematoma, and Sixth Cranial Nerve Palsy Lumbar Following Spinal Drain, Resolved
Edward M Walton1, Lisa V Doan1
1Department of Anesthesiology, Perioperative Care & Pain Management, New York University Grossman School of Medicine, New York, NY.
Background:
Postdural puncture headache (PDPH) is a known potential complication of lumbar drain placement. Data regarding incidence of PDPH after lumbar drain placement varies, with a range of 0% to 47%. Furthermore, spinal drain placement has been associated with a significantly increased risk of debilitating neurologic complications.
Case Report:
In this article, we describe the case of a patient who developed PDPH, subdural hematoma, and abducens nerve palsy after lumbar drain. The patient was treated successfully with epidural blood patch. To our knowledge, this is the first case report of a patient who developed all 3 of these complications following spinal drain placement.
Conclusion:
Dural puncture, whether accidental or purposeful, carries a risk of multiple serious neurological sequelae. After spinal drain placement, close monitoring for symptoms of intracranial hypotension should ensue with a plan for treatment in the event the patient develops a PDPH or other neurologic sequelae.
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