scholarly journals Don’t Forget Rare Causes of Postpartum Headache! Cases Report and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 376
Author(s):  
Marco Di Paolo ◽  
Aniello Maiese ◽  
Ornella Mangiacasale ◽  
Barbara Pesetti ◽  
Simone Pierotti ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Health Professionals ◽  
Postpartum Period ◽  
Dural Puncture ◽  
Careful Examination ◽  
Common Finding ◽  
Post Dural Puncture Headache ◽  
High Level ◽  
Postpartum Headache ◽  
Neuroradiological Imaging

Headache is a common finding in the postpartum period, caused by a spectrum of different conditions. Most headaches in the postpartum period are self-limiting and benign in etiology, but there are some potentially serious causes to be considered. We disclose two cases of postpartum headache, initially considered as post-dural puncture headache (PDPH), that evolved into a harmful condition and showed that an expanded differential diagnosis for headache in the postpartum is mandatory, requiring a high level of attention from health professionals. In fact, a careful examination of the medical history, physical examination, and the recognition for the need for early neuroradiological imaging should incre[se diagnostic accuracy.

scholarly journals Post partum headache: a case series

2018 ◽  
Vol 8 (1) ◽  
pp. 317
Author(s):  
Reema Kumar Bhatt ◽  
Rohin Kumar ◽  
L. B. Singh
Keyword(s):  
Dural Puncture ◽  
Sinus Thrombosis ◽  
Post Partum ◽  
Case Series ◽  
Diagnostic Dilemma ◽  
Post Dural Puncture Headache ◽  
Cortical Vein ◽  
First Case ◽  
Cortical Vein Thrombosis ◽  
Postpartum Headache

Postpartum headache is the complaint of head, neck, or shoulder pain occurring during the first 6 weeks following delivery. Among the women who underwent neuraxial aneasthesia Post Dural puncture headache is one of the most common presentations. However, physicians should be aware that post Dural puncture headache is not the only cause of postpartum headache. Authors present a series of four cases that had varied presentation of post partum headache with varied diagnosis, the first case was of subdural haematoma where CT scan revealed an acute on chronic SDH. The second case was diagnosed as meningitis and the CSF for culture sensitivity grew Streptococcus Pneumoniae .In our third case of cortical vein  thrombosis , NCCT followed by MR venogram  revealed left transverse venous sinus thrombosis and our last case in the series was of posterior reversible encephalopathy syndrome where MRI confirmed the findings of typical findings are symmetric edema involving the white matter of the posterior regions of the cerebral hemispheres. The diagnostic dilemma was resolved by neuroimaging because the clinical presentation was not making us reach a satisfactory diagnosis of the cause of headache. Early resort to neuroimaging and multidisciplinary team effort paved way to early diagnosis and appropriate recovery of the patients.

scholarly journals Postpartum post-dural puncture headache: is your differential diagnosis complete?

2004 ◽  
Vol 93 (3) ◽  
pp. 461-464 ◽  
Author(s):  
C.P. Bleeker ◽  
I.M. Hendriks ◽  
L.H. D.J. Booij
Keyword(s):  
Differential Diagnosis ◽  
Dural Puncture ◽  
Post Dural Puncture Headache

scholarly journals Chronic Subdural Hematoma, a Cause of Persistent Post-Dural Puncture Headache in the Postpartum Period

2021 ◽  
Vol 11 (03) ◽  
pp. 272-278
Author(s):  
Daniel Kanyata ◽  
Omar Ahmed Nassir ◽  
Christopher K. Musau ◽  
Victoria Adhiambo Gamba ◽  
Mariatu Tamimu ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Postpartum Period ◽  
Dural Puncture ◽  
Chronic Subdural Hematoma ◽  
Post Dural Puncture Headache

scholarly journals A Case of Postpartum Headache Post Dural Puncture. Post Dural Puncture Headache or Reversible Cerebral Vasoconstriction Syndrome - Posterior Reversible Encephalopathy Syndrome?

2020 ◽  
Author(s):  
Melania Turetti ◽  
Maria Barbagallo ◽  
Umberto Scoditti ◽  
Antonio Genovese ◽  
Laura Angeli ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Dural Puncture ◽  
Postpartum Woman ◽  
Unexpected Event ◽  
Post Dural Puncture Headache ◽  
Posterior Reversible Encephalopathy ◽  
Cerebral Vasoconstriction ◽  
Reversible Encephalopathy ◽  
Prompt Diagnosis ◽  
Postpartum Headache

Abstract BACKGROUNDReversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES) are two rare neurological conditions, clinically characterized of headache. This is sometimes difficult to differentiate from post dural puncture headache (PDPH). In our case a diagnosis of PDPH was made but imaging showed signs of RCVS-PRES. The novelty is that, unlike in cases reported in literature, no liquoral hypotension signs were detected on imaging.CASE PRESENTATIONWe present a case of RCVS-PRES in a postpartum woman that presented headache as first symptom, and only later experienced seizures. Epidural analgesia was performed during labour, and it was complicated by dural puncture that worked as a confounding factor in the clinical postpartum evaluation. Seizures represented an unexpected event in the course of treating this patient for post dural puncture headache.CONCLUSIONSWe point out the attention on changes of clinical characteristics of headache as an important factor to be analyzed, in order to have a prompt diagnosis. Moreover, we evaluate possible triggers of RCVS and PRES; in our case dural puncture is probably not the trigger, in fact there were no liquoral hypotension signs on imaging. According to literature reports, puerperium itself was a promoting factor.

scholarly journals Comparisons of clinical characteristics, brain MRI findings, and responses to epidural blood patch between spontaneous intracranial hypotension and post-dural puncture headache: retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gha-Hyun Lee ◽  
Jiyoung Kim ◽  
Hyun-Woo Kim ◽  
Jae Wook Cho
Keyword(s):  
Intracranial Hypotension ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Brain Mri ◽  
Spontaneous Intracranial Hypotension ◽  
Vein Of Galen ◽  
Mri Findings ◽  
Post Dural Puncture Headache ◽  
Straight Sinus ◽  
Blood Patch

Abstract Background Spontaneous intracranial hypotension and post-dural puncture headache are both caused by a loss of cerebrospinal fluid but present with different pathogeneses. We compared these two conditions concerning their clinical characteristics, brain imaging findings, and responses to epidural blood patch treatment. Methods We retrospectively reviewed the records of patients with intracranial hypotension admitted to the Neurology ward of the Pusan National University Hospital between January 1, 2011, and December 31, 2019, and collected information regarding age, sex, disease duration, hospital course, headache intensity, time to the appearance of a headache after sitting, associated phenomena (nausea, vomiting, auditory symptoms, dizziness), number of epidural blood patch treatments, and prognosis. The brain MRI signs of intracranial hypotension were recorded, including three qualitative signs (diffuse pachymeningeal enhancement, venous distention of the lateral sinus, subdural fluid collection), and six quantitative signs (pituitary height, suprasellar cistern, prepontine cistern, mamillopontine distance, the midbrain-pons angle, and the angle between the vein of Galen and the straight sinus). Results A total of 105 patients (61 spontaneous intracranial hypotension patients and 44 post-dural puncture headache patients) who met the inclusion criteria were reviewed. More patients with spontaneous intracranial hypotension required epidural blood patch treatment than those with post-dural puncture headache (70.5% (43/61) vs. 45.5% (20/44); p = 0.01) and the spontaneous intracranial hypotension group included a higher proportion of patients who underwent epidural blood patch treatment more than once (37.7% (23/61) vs. 13.6% (6/44); p = 0.007). Brain MRI showed signs of intracranial hypotension in both groups, although the angle between the vein of Galen and the straight sinus was greater in the post-dural puncture headache group (median [95% Confidence Interval]: 85° [68°-79°] vs. 74° [76°-96°], p = 0.02). Conclusions Patients with spontaneous intracranial hypotension received more epidural blood patch treatments and more often needed multiple epidural blood patch treatments. Although both groups showed similar brain MRI findings, the angle between the vein of Galen and the straight sinus differed significantly between the groups.

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