Related Experiment Videos
Puerperal seizures after post-dural puncture headache
V E Shearer1, H S Jhaveri, F G Cunningham
1Department of Anesthesiology, University of Texas Southwestern Medical Center at Dallas.
Obstetrics and Gynecology
|February 1, 1995
Summary
Postpartum seizures can occur after spinal headaches, potentially caused by cerebral vasoconstriction. This condition, linked to post-dural puncture headache, may also cause visual disturbances and cranial nerve palsies.
Area of Science:
- Neurology
- Obstetrics
- Anesthesiology
Background:
- Post-dural puncture headache (PDPH) is a known complication following spinal anesthesia.
- Seizures are an uncommon but serious neurological event that can occur postpartum.
Purpose of the Study:
- To report on a series of postpartum women who experienced seizures secondary to post-dural puncture headache.
- To investigate the potential mechanism linking PDPH to seizures.
Main Methods:
- Retrospective case series analysis of over 19,000 women receiving subarachnoid analgesia between 1982-1991.
- Clinical observation and diagnostic evaluation of eight women who developed seizures post-spinal anesthesia.
Main Results:
- Eight postpartum women developed generalized tonic-clonic seizures 2-7 days after PDPH.
- Associated symptoms included visual disturbances, progressing to cortical blindness in three cases.
- Cerebral artery vasospasm or reduced regional blood flow was identified in three evaluated patients.
Conclusions:
- Cerebral vasoconstriction is proposed as the underlying mechanism for PDPH-associated seizures.
- Anatomic brain displacement may trigger this vasospasm.
- This mechanism could also explain cranial nerve palsies observed after dural puncture.