Management of postdural puncture headache with epidural blood patch in children.
BACKGROUND
Until the last decade, it was believed that postdural puncture headache (PDPH) was an uncommon complaint in children, but recent studies indicate that young children may develop PDPH after spinal puncture. When the symptoms are severe and are not relieved within a few days with analgesics, forced hydration and bed rest, then epidural blood patch (EBP) might be performed.


METHODS
In this retrospective survey, we analysed EBP performed in Kuopio University Hospital between the years 1995 and 2000.


RESULTS
During the 6-year period, seven EBP were performed in children aged 12 years or younger. Four out of the seven children had undergone a diagnostic spinal puncture, two had spinal anaesthesia and one child had spinal puncture for treatment of postoperative hygroma. Five children had a typical PDPH, one child had a cerebrospinal fluid fistula headache and one child had a headache similar to his migraine. EBP was performed 2-19 days after spinal puncture with 0.3 ml.kg-1 (mean) of autologous blood injected into the epidural space.


CONCLUSIONS
EBP gave some relief of symptoms in all children. No complications related to EBP were noticed.
Ylönen
Paula
P
Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Finland.
Kokki
Hannu
H
D017217:Blood Patch, Epidural; D002648:Child; D016208:Databases, Factual; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D011187:Posture; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000009:adverse effects*; D013997:Time Factors