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Case Reports
Late Recurrence of Postdural Puncture Headache
  1. David Sidebotham, M.B.Ch.B.*,
  2. Ernest Willoughby, FRACP† and
  3. Stephan A. Schug, M.D*,‡
  1. *Acute Pain Service, Department of Anaesthesia, Auckland Hospital, the
  2. †Department of Neurology, Auckland Hospital, School of Medicine, University of Auckland, Auckland, New Zealand
  3. ‡Section of Anaesthetics, Department of Pharmacology, School of Medicine, University of Auckland, Auckland, New Zealand
  1. Reprint requests: Professor Stephan A. Schug, M.D., Section of Anaesthetics, Department of Pharmacology, School of Medicine, University of Auckland, Private Bag 92 019, Auckland, New Zealand.

Abstract

Background and Objectives Postdural puncture headache can recur following an epidural blood patch but usually does so within the first week. However, a late recurrence was encountered in a 31-year-old woman with probable lupus vasculitis.

Methods The patient underwent a diagnostic lumbar puncture and suffered a postdural puncture headache. She was treated with an epidural blood patch and had complete resolution of her headache. Five weeks later, she suffered a sudden recurrence of an identical headache and underwent a repeat epidural blood patch.

Results The second headache, like the first, was immediately and completely resolved.

Conclusions A review of risk factors for postdural puncture headache and the role of an epidural blood patch suggests a possible explanation for the late recurrence in this case.

  • postdural puncture headache
  • epidural blood patch
  • lumbar puncture
  • complications

https://doi.org/10.1136/rapm-00115550-199722040-00016

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