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Late recurrence of postdural puncture headache
D Sidebotham1, E Willoughby, S A Schug
1Department of Anaesthesia, Auckland Hospital, New Zealand.
Regional Anesthesia
|July 1, 1997
Summary
Late-occurring postdural puncture headaches can happen, even after an epidural blood patch. This case highlights a potential recurrence in a patient with lupus vasculitis, emphasizing the need for continued monitoring.
Area of Science:
- Neurology
- Anesthesiology
- Rheumatology
Background:
- Postdural puncture headache (PDPH) is a common complication after lumbar puncture.
- Epidural blood patch (EBP) is an effective treatment for PDPH, typically resolving symptoms within days.
- While recurrence is possible, late recurrence of PDPH is uncommon.
Observation:
- A 31-year-old woman experienced a PDPH after a diagnostic lumbar puncture.
- She received an EBP, which provided complete headache relief.
- Five weeks post-EBP, she presented with a sudden recurrence of an identical headache.
Findings:
- The patient's late-recurring PDPH was successfully treated with a second EBP.
- The recurrence occurred significantly later than the typical timeframe for PDPH relapse.
- The patient had a history of probable lupus vasculitis, a potential contributing factor.
Implications:
- This case suggests that late recurrence of PDPH is possible, even after successful initial treatment.
- Underlying conditions like lupus vasculitis may influence the timing and recurrence of PDPH.
- Further investigation into risk factors for late PDPH recurrence is warranted.