Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942011000300011
Brazilian Journal of Anesthesiology
Clinical Information

Cefaleia após anestesia subaracnoidea com sete meses de evolução: relato de caso

Post-dural headache with seven months duration: case report

Fabiano Timbó Barbosa

http://dx.doi.org/10.1590/S0034-70942011000300011 Braz J Anesthesiol, vol.61, n3, p.357-359, 2011
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Resumo

JUSTIFICATIVA E OBJETIVOS: A cefaleia pós-punção dural é uma complicação possível e esperada em uma pequena parcela dos casos após a realização da raquianestesia. Este relato teve por objetivo descrever a conduta terapêutica tomada diante de um caso de cefaleia pós-punção de dura-máter com sete meses de evolução. RELATO DO CASO: Paciente do sexo feminino, 40 anos, previamente saudável, apresentou-se ao hospital em quadro de cefaleia com sete meses de duração e que teve início após a realização de raquianestesia. Ao ser examinada, relatou que alguns analgésicos e a posição de decúbito lhe traziam alívio parcial da dor. Após a suspeita de cefaleia pós-punção dural, realizou-se um tampão sanguíneo peridural, com resolução completa do quadro. Recebeu alta hospitalar sem queixas. CONCLUSÕES: O presente caso demonstrou que o tampão sanguíneo peridural foi eficaz no tratamento da cefaleia crônica pós-punção dural em um caso com sete meses de duração.

Palavras-chave

COMPLICAÇÕES, Cefaleia, SANGUE, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: Post-dural puncture headache is a possible and expected complication in a small percentage of cases after spinal anesthesia. The objective of the current report was to describe the therapeutic conduct in a case of post-dural puncture headache with seven months of evolution. CASE REPORT: A 40-year-old healthy female who complained of headache for seven months, which began after spinal anesthesia. She reported that some analgesics and decubitus position provided partial pain relief. An epidural blood patch was performed, with complete resolution of pain. She was discharged without complaints. CONCLUSIONS: This case demonstrated that the epidural blood patch was effective in the treatment of chronic post-dural puncture headache in a case with seven-month evolution.

Keywords

Post-Dural Puncture Headache, Anesthesia, Spinal, Blood Patch, Epidural

References

Klepstad P. Relief of postdural puncture headache by an epidural blood patch 12 months after dural puncture. Acta Anaesthesiol Scand. 1999;43:964-966.

MacArthur C, Lewis M, Knox EG. Accidental dural puncture in obstetric patients and long term symptoms. BMJ. 1993;306:883-885.

Ferre JP, Gentil ME. Seven months delay for epidural blood patch in post-dural puncture headache. Eur J Anesthesiol. 1999;16:257-258.

Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. BMJ. 2003;91:718-729.

Pedrosa GC, Jardim JL, Palmeira MA. Tampão Sanguíneo Peridural e a Alta Hospitalar Precoce: Análise de 60 Pacientes Portadores de Cefaleia Pós-Raquianestesia. Rev Bras Anestesiol. 1996;46:8-12.

Evans RW, Armon C, Frohman EM. Assessment: prevention of post-lumbar puncture headaches. Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology. 2000;55:909-914.

Gaiser R. Postdural puncture headache. Curr Opin Anaesthesiol. 2006;19:249-253.

Vandam LD, Dripps RD. Long-term follow-up of patients who received 10 098 spinal anesthetics. JAMA. 1954;156:1486-1491.

Barbosa FT, Cunha RM. É possível usar a hidrocortisona no tratamento da cefaleia após raquianestesia. Rev Bras Anestesiol. 2007;57:450-451.

Grant R, Condon B, Hart I. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psych. 1991;54:440-442.

Yentis SM, Haire K. Epidural blood patch for atypical headache following obstetrical epidural analgesia. Anaesthesia. 1997;52:62-64.

Cooper G. Epidural blood patch. Eur J Anaesthesiol. 1999;16:211-215.

Cavicchio A, Imbelloni LE. Cefaleia Pós-Punção. Tratado de Anestesia Raquidiana. 2001:178-191.

Bernards CM. Epidural and spinal anesthesia. Clinical Anesthesia. 2006:691-617.

Flaatten H, Felthaus J, Kuwelker M. Postural post-dural puncture headache: A prospective randomised study and a meta-analysis comparing two different 0.40 mm O.D. (27g) spinal needles. Acta Anaesthesiol Scand. 2000;44:643-647.

Wilton NCT, Globerson H, Rosayro AM. Epidural blood patch for postdural puncture headache: its never too late. Anesthesia and Analgesia. 1986;65:895-896.

Kshatri AM, Foster PA. Adrenocorticotropic hormone infusion as a novel treatment for postdural puncture headache. Reg Anesth. 1997;22:432-434.

Polpun B, Suhattaya B. Epidural blood patching for preventing and treating post-dural puncture headache: Cochrane Database of Systematic Reviews. Cochrane Library. .

Davies JM, Murphy A, Smith M. Subdural haematoma after dural puncture headache treated by epidural blood patch. Br J Anaesth. 2001;86:720-723.

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