Dural puncture and headache.

Reynolds, F.

doi:10.1136/bmj.306.6882.874

Cited by 146 publications

(78 citation statements)

References 22 publications

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“…The experimental system used in this study was flushed with sterile saline solution. The advantages of using saline instead of air to perform an epidural puncture are documented in the literature [11][12][13]. The clinical advantages of epidural anaesthesia are well established [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

Clinical results with a new acoustic device to identify the epidural space

Lechner¹,

Wijk²,

Maas

2002

Anaesthesia

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SummaryFifty patients scheduled for surgery under lumbar epidural anaesthesia were included in a study to evaluate the possibility of localising the epidural space solely by means of an acoustic signal. With an experimental set-up, the pressure generated during the epidural puncture procedure was translated into a corresponding acoustic signal. One anaesthetist held the epidural needle with both hands and detected the epidural space by means of this acoustic signal. At the same time, a second anaesthetist applied the loss of resistance technique and functioned as control. In all patients the epidural space was located with the acoustic signal. This was confirmed by conventional loss of resistance in 49 (98%) of the patients; in one patient (2%) it was not. We conclude that it is possible to locate the epidural space using an acoustic signal alone.

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Section: Discussionmentioning

confidence: 99%

Clinical results with a new acoustic device to identify the epidural space

Lechner¹,

Wijk²,

Maas

2002

Anaesthesia

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“…This contributed to a delayed diagnosis. Due to its nature, unrecognised dural punctures are not detected early and a persistent dural leak, if neglected, has sinister neurological consequences and could even result in a death [19]. The management of such complex cases require complex neuroradiological investigations and seeking early specialist neurology opinion may expedite diagnosis and effective treatment.…”

Section: Discussionmentioning

confidence: 99%

Unrecognised dural puncture resulting in subdural hygroma and cortical vein thrombosis

Sinha¹,

Petkov²,

Meldrum

2009

Anaesthesia

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SummaryUnrecognised dural punctures are difficult to diagnose early. Failure of recognition may lead to sinister consequences. A case of unrecognised dural puncture in a young female leading to the development of subdural hygroma and cortical vein thrombosis is presented. The dilemma in the diagnosis of headache in such patients along with the significance of follow‐up of all, including attempted, epidurals is also discussed.

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“…The lumbar spinal cord, meninges and adjacent structures (bones, ganglion and nerve) were examined for haemorrhage, congestion, dilation, fibrosis and necrosis. The sample size was estimated according to Blackwelder's formula: (Z 0.95 + Z 0.80 ) 2 2 . Ps represents the proportion of rats without medullary lesions using the standard therapy and Pn represents the proportion of rats without medullary lesions using the new therapy.…”

Section: Methodsmentioning

confidence: 99%

“…It is a common iatrogenic cause of morbidity [1][2][3] that may have serious complications [4] and increase hospital length of stay and visits to the emergency department [5]. Epidural blood patch has become the gold standard treatment for PDPH [6,7].…”

Section: Introductionmentioning

confidence: 99%

Neurotoxicity of intrathecal 6% hydroxyethyl starch 130/0.4 injection in a rat model

et al. 2015

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SummaryEpidural blood patch is the gold standard treatment for post-dural puncture headache, although hydroxyethyl starch may be a useful alternative to blood if the latter is contraindicated. The aim of this experimental study was to assess whether hydroxyethyl starch given via an indwelling intrathecal catheter resulted in clinical or histopathological changes suggestive of neurotoxicity. The study was conducted in rats that were randomly allocated to receive three 10-ll injections on consecutive days of either saline or hydroxyethyl starch administered via the intrathecal catheter. Eight rats were given injections of saline 0.9% and 11 were given 6% hydroxyethyl starch 130/0.4 derived from thin boiling waxy corn starch in 0.9% sodium chloride (Voluven â ). Daily clinical evaluation, activity measured by actimetry and neuropathological analysis of the spinal cord were subsequently performed to assess for signs of neurotoxicity. No clinical or actimetric changes were observed in either group following intrathecal saline or hydroxyethyl starch administration. Histopathological examination showed non-specific changes with no differences between the two groups. This experimental study in the rat suggests that repeated intrathecal injection of hydroxyethyl starch is not associated with neurotoxicity.

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Dural puncture and headache.

Abstract: Report of the joint working party on medical senrices for children.

Cited by 146 publications

References 22 publications

Clinical results with a new acoustic device to identify the epidural space

Clinical results with a new acoustic device to identify the epidural space

Unrecognised dural puncture resulting in subdural hygroma and cortical vein thrombosis

Neurotoxicity of intrathecal 6% hydroxyethyl starch 130/0.4 injection in a rat model

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