Cefalea post punción dural
Post-dural puncture headache.
Ghaleb A, Khorasani A, Mangar D.
Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Int J Gen Med. 2012;5:45-51. doi: 10.2147/IJGM.S17834. Epub 2012 Jan 12.
Abstract
Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH) has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24-48 hours of dural puncture. The optimum volume of blood has been shown to be 12-20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP) are rare.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265991/pdf/ijgm-5-045.pdf
Cefalea post punción dural
Postdural puncture headache.
Ghaleb A.
Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 515, Little Rock, AR 72205, USA.
Anesthesiol Res Pract. 2010;2010. pii: 102967. doi: 10.1155/2010/102967. Epub 2010 Aug 11.
Abstract
Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to theepidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24-48 h of dural puncture. The optimum volume of bloodhas been shown to be 12-20 mL for adult patients. Complications of AEBP are rare.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931374/pdf/ARP2010-102967.pdf
Cefalea post punción dural: patogénesis, prevención y tratamiento
Post-dural puncture headache: pathogenesis, prevention and treatment.
Turnbull DK, Shepherd DB.
Academic Anaesthetic Unit, University of Sheffield, K Floor, Royal Hallamshire Hospital, Sheffield, UK. totleytiger@yahoo.co.uk
Br J Anaesth. 2003 Nov;91(5):718-29.
Abstract
Spinal anaesthesia developed in the late 1800s with the work of Wynter, Quincke and Corning. However, it was the German surgeon, Karl August Bier in 1898, who probably gave the first spinal anaesthetic. Bier also gained first-hand experience of the disabling headache related to dural puncture. He correctly surmised that the headache was related to excessive loss of cerebrospinal fluid (CSF). In the last 50 yr, the development of fine-gauge spinal needles and needle tip modification, has enabled a significant reduction in the incidence of post-dural puncture headache. Though it is clear that reducing the size of the dural perforation reduces the loss of CSF, there are many areas regarding the pathogenesis, treatment and prevention of post-dural puncture headache that remain contentious. How does the microscopic pattern of collagen alignment in the spinal dura affect the dimensions of the dural perforation? How do needle design, size and orientation influence leakage of CSF through the dural perforation? Can pharmacological methods reduce the symptoms of post-dural puncture headache? By which mechanism does the epidural blood patch cure headache? Is there a role for the prophylactic epidural blood patch? Do epidural saline, dextran, opioids and tissue glues reduce the rate of CSF loss? This review considers these contentious aspects of post-dural puncture headache.
http://bja.oxfordjournals.org/content/91/5/718.full.pdf
Realidades terapéuticas de la cefalea postpunción dural
Dr. Manuel Marrón-Peña, Dr. José Emilio Mille-Loera
Rev Mex Anestesiología 2013;36: Supl. 1 Abril-Junio 2013 pp S277-S282
http://www.medigraphic.com/pdfs/rma/cma-2013/cmas131bm.pdf
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Post-dural puncture headache.
Ghaleb A, Khorasani A, Mangar D.
Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Int J Gen Med. 2012;5:45-51. doi: 10.2147/IJGM.S17834. Epub 2012 Jan 12.
Abstract
Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH) has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24-48 hours of dural puncture. The optimum volume of blood has been shown to be 12-20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP) are rare.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265991/pdf/ijgm-5-045.pdf
Cefalea post punción dural
Postdural puncture headache.
Ghaleb A.
Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 515, Little Rock, AR 72205, USA.
Anesthesiol Res Pract. 2010;2010. pii: 102967. doi: 10.1155/2010/102967. Epub 2010 Aug 11.
Abstract
Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to theepidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24-48 h of dural puncture. The optimum volume of bloodhas been shown to be 12-20 mL for adult patients. Complications of AEBP are rare.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931374/pdf/ARP2010-102967.pdf
Cefalea post punción dural: patogénesis, prevención y tratamiento
Post-dural puncture headache: pathogenesis, prevention and treatment.
Turnbull DK, Shepherd DB.
Academic Anaesthetic Unit, University of Sheffield, K Floor, Royal Hallamshire Hospital, Sheffield, UK. totleytiger@yahoo.co.uk
Br J Anaesth. 2003 Nov;91(5):718-29.
Abstract
Spinal anaesthesia developed in the late 1800s with the work of Wynter, Quincke and Corning. However, it was the German surgeon, Karl August Bier in 1898, who probably gave the first spinal anaesthetic. Bier also gained first-hand experience of the disabling headache related to dural puncture. He correctly surmised that the headache was related to excessive loss of cerebrospinal fluid (CSF). In the last 50 yr, the development of fine-gauge spinal needles and needle tip modification, has enabled a significant reduction in the incidence of post-dural puncture headache. Though it is clear that reducing the size of the dural perforation reduces the loss of CSF, there are many areas regarding the pathogenesis, treatment and prevention of post-dural puncture headache that remain contentious. How does the microscopic pattern of collagen alignment in the spinal dura affect the dimensions of the dural perforation? How do needle design, size and orientation influence leakage of CSF through the dural perforation? Can pharmacological methods reduce the symptoms of post-dural puncture headache? By which mechanism does the epidural blood patch cure headache? Is there a role for the prophylactic epidural blood patch? Do epidural saline, dextran, opioids and tissue glues reduce the rate of CSF loss? This review considers these contentious aspects of post-dural puncture headache.
http://bja.oxfordjournals.org/content/91/5/718.full.pdf
Realidades terapéuticas de la cefalea postpunción dural
Dr. Manuel Marrón-Peña, Dr. José Emilio Mille-Loera
Rev Mex Anestesiología 2013;36: Supl. 1 Abril-Junio 2013 pp S277-S282
http://www.medigraphic.com/pdfs/rma/cma-2013/cmas131bm.pdf
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
