IV Theophylline Quickly Reduces Lumbar Puncture HeadacheIV Theophylline Quickly Reduces Lumbar Puncture Headache

A small study shows that the pain common after lumbar puncture or spinal anesthesia quickly resolves with IV theophylline, with the greatest relief in the first 30 minutes but continuing out to 60 minutes. Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Neurology & Neurosurgery News Source Type: news

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AbstractPurpose of ReviewPost dural puncture headache (PDPH) is a relatively common complication which may occur in the setting of inadvertent dural puncture (DP) during labor epidural analgesia and during intentional DP during spinal anesthetic placement or diagnostic lumbar puncture. Few publications have established the long-term safety of an epidural blood patch (EBP) for the treatment of a PDPH.Recent FindingsThe aim of this pilot study was to examine the association of chronic low back pain (LBP) in patients who experienced a PDPH following labor analgesia and were treated with an EBP. A total of 146 patients were co...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
ConclusionsIH is an under-recognized cause of seizure following the spinal or cranial surgery, lumbar puncture, or spinal anesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow, and cortical irritation secondary to subdural hygromas.
Source: Neurocritical Care - Category: Neurology Source Type: research
Discussion. Pneumocephalus is defined by two mechanisms: a ball-valve and an inverted bottle concept.1 The ball-valve type implies positive pressure events, such as coughing or valsalva maneuvers, that prevent air escape. Tension pneumocephalus is included in this mechanism, causing a parenchymal mass effect. The inverted bottle theory includes a negative intracranial pressure gradient following cerebrospinal fluid drainage, relieved by air influx. A small pneumocephalus is usually sealed by blood clots or granulation, allowing spontaneous reabsorption and resolution.[1] Otherwise, the lateral positioning of a patient duri...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Assessment Tools CNS Infections Current Issue Letters to the Editor Neurologic Systems and Symptoms Neurology Stroke Traumatic Brain Injury epidural needle size Pneumocephalus spinal tap Source Type: research
Conclusions: Ineffectiveness of conservative measures and epidural blood patches performed posteriorly to resolve PDPH should lead the physician both to question the diagnosis of PDPH by pursuing radiographic confirmation of a cerebral spinal fluid leak and, furthermore, identification of its location to best direct further therapy.
Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Pediatric Analgesia: Case Report Source Type: research
CONCLUSIONS: Ineffectiveness of conservative measures and epidural blood patches performed posteriorly to resolve PDPH should lead the physician both to question the diagnosis of PDPH by pursuing radiographic confirmation of a cerebral spinal fluid leak and, furthermore, identification of its location to best direct further therapy. PMID: 28178090 [PubMed - as supplied by publisher]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Reg Anesth Pain Med Source Type: research
(A A Case Rep. 2016;6:160–162) In this case report, a 32-year-old primigravida woman with a history of idiopathic intracranial hypertension (IIH) presented to the labor and delivery suite at 40 weeks gestation in active labor and with pseudotumor cerebri syndrome (PTCS). PTCS, which includes IIH, is a rare disorder mainly of obese women of childbearing age, characterized by increased intracranial pressure in the absence of a space-occupying lesion, ventriculomegaly, or abnormal cerebrospinal fluid (CSF) composition. Symptoms include headache, pulsatile tinnitus, back pain, dizziness, photophobia, neck pain, cognitiv...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Case Reports Source Type: research
CONCLUSIONS: Valsalva can be performed routinely in ASA I and II patients undergoing spinal anesthesia as it is safe, painless and non-pharmacological method of pain attenuation. PMID: 26885298 [PubMed]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Postdural puncture headache (PDPH), also known as spinal headache, is a common complication associated with neuraxial anesthesia and diagnostic lumbar puncture. Autologous epidural blood patch is considered the definitive treatment for PDPH with efficacy greater than 75%; but it is an invasive procedure that carries the same risks as other epidural procedures, including dural puncture, infection, and neurologic complications [1–3]. Transnasal sphenopalatine ganglion block (SPGB) has been traditionally used to treat chronic conditions such as migraine, cluster headache, trigeminal neuralgia, and atypical facial pain [...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Case Report Source Type: research
Postdural puncture headache (PDPH), also known as spinal headache, is a common complication associated with neuraxial anesthesia and diagnostic lumbar puncture. Autologous epidural blood patch (AEBP) is considered the definitive treatment for PDPH with efficacy over 75%, but it is an invasive procedure that carries the same risks as other epidural procedures, including dural puncture, infection, and neurologic complications.[1,2,3] Transnasal sphenopalatine ganglion block (SPGB) has been used traditionally used to treat chronic conditions such as migraine, cluster headache, trigeminal neuralgia, and atypical facial pain, [...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Case Report Source Type: research
This study showed that the duration of absorption of 50 ml of air decreased from 5.8 to 1.9 weeks by 40% FiO2 from 1.9 to 0.6 weeks on room air and 100% FiO2, respectively. (Anesthesiology 1996;84[2]:442.)     Several diagnoses should be added to the headache differential diagnosis in the case of a patient receiving recent epidural spinal injections. Post-procedural headache or low-pressure headache, as well as pneumocephalus, should be added to the differential. The patient can be easily placed on a face mask to expedite air resorption, and can be provided symptom control as needed. This patient was...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
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