Case report: Epidural blood patch in the treatment of abducens palsy after a dural puncture
| Autor: | Pierre Dolbec, Annie Labourdette, Gino Perron, Denis Larochelle, Philippe Béchard, Mélanie Lacroix |
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| Rok vydání: | 2007 |
| Předmět: |
Anesthesia
Epidural musculoskeletal diseases medicine.medical_specialty Time Factors Spinal Puncture Treatment failure Humans Medicine Treatment Failure Intracranial Hypotension Abducens nerve Epidural blood patch Palsy business.industry Diagnostic lumbar puncture General Medicine Middle Aged Abducens palsy Sixth Cranial Nerve Palsy Surgery Anesthesiology and Pain Medicine Anesthesia Female business Blood Patch Epidural Abducens Nerve Diseases |
| Zdroj: | Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 54:146-150 |
| ISSN: | 1496-8975 0832-610X |
| Popis: | To describe a case of iatrogenically induced abducens nerve palsy following a diagnostic lumbar puncture, and to review the evidence for blood patching in the management of sixth cranial nerve palsy after dural puncture.A 45-yr-old woman developed post-dural puncture headache with bilateral abducens palsy following a diagnostic lumbar puncture. Magnetic resonance imaging showed findings compatible with intracranial hypotension. An epidural blood patch was performed five days after the onset of diplopia and ten days following the dural puncture. After blood patching, the patient reported relief of the headache, but still complained of diplopia. The palsies recovered spontaneously 21 months after the dural puncture.Experience from this case as well as other case report evidence suggest that an epidural blood patch performed more than 24 hr after the onset of a sixth cranial nerve palsy consistently fails to relieve diplopia. An epidural blood patch executed within 24 hr from the onset of diplopia could possibly lead to partial improvement and/or earlier resolution of symptoms. |
| Databáze: | OpenAIRE |
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