{"title":"难治性硬脑膜穿刺后头痛1例未确诊的胸内脑膜膨出。","authors":"Dr Reena, Subash Sankaralingam, Swati Singh, Amrita Rath, J Manikandan, Ashutosh Vikram","doi":"10.14744/agri.2024.46667","DOIUrl":null,"url":null,"abstract":"<p><p>Post dural puncture headache (PDPH) is a troublesome complication of dural puncture. Although its risk factors and management have been extensively discussed in the literature, the underlying cause may sometimes remain unclear, making treatment challenging for anaesthesiologists. We describe a noteworthy case of PDPH following spinal anaesthesia administered for an emergency cesarean section in a patient with known neurofibromatosis. Despite conservative and pharmacological treatment, followed by an autologous epidural blood patch, no symptomatic relief was achieved. Neuroimaging of the brain and spine revealed a large intrathoracic meningocele (IM). Although rare, intrathoracic meningocele should be considered in patients with neurofibromatosis who develop intractable PDPH after dural puncture, with neuroimaging being the most effective diagnostic tool.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"121-124"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intractable post dural puncture headache in a patient with undiagnosed intrathoracic meningocele.\",\"authors\":\"Dr Reena, Subash Sankaralingam, Swati Singh, Amrita Rath, J Manikandan, Ashutosh Vikram\",\"doi\":\"10.14744/agri.2024.46667\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Post dural puncture headache (PDPH) is a troublesome complication of dural puncture. Although its risk factors and management have been extensively discussed in the literature, the underlying cause may sometimes remain unclear, making treatment challenging for anaesthesiologists. We describe a noteworthy case of PDPH following spinal anaesthesia administered for an emergency cesarean section in a patient with known neurofibromatosis. Despite conservative and pharmacological treatment, followed by an autologous epidural blood patch, no symptomatic relief was achieved. Neuroimaging of the brain and spine revealed a large intrathoracic meningocele (IM). Although rare, intrathoracic meningocele should be considered in patients with neurofibromatosis who develop intractable PDPH after dural puncture, with neuroimaging being the most effective diagnostic tool.</p>\",\"PeriodicalId\":101341,\"journal\":{\"name\":\"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology\",\"volume\":\"37 2\",\"pages\":\"121-124\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14744/agri.2024.46667\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/agri.2024.46667","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Intractable post dural puncture headache in a patient with undiagnosed intrathoracic meningocele.
Post dural puncture headache (PDPH) is a troublesome complication of dural puncture. Although its risk factors and management have been extensively discussed in the literature, the underlying cause may sometimes remain unclear, making treatment challenging for anaesthesiologists. We describe a noteworthy case of PDPH following spinal anaesthesia administered for an emergency cesarean section in a patient with known neurofibromatosis. Despite conservative and pharmacological treatment, followed by an autologous epidural blood patch, no symptomatic relief was achieved. Neuroimaging of the brain and spine revealed a large intrathoracic meningocele (IM). Although rare, intrathoracic meningocele should be considered in patients with neurofibromatosis who develop intractable PDPH after dural puncture, with neuroimaging being the most effective diagnostic tool.