[Headache caused by cerebral angiopathy during labor with epidural analgesia].
A 29-year-old woman presented projectile vomiting followed by frontal headache, immediately upon receiving epidural analgesia for labor. The clinical picture persisted until expulsion. Although no leaking of spinal fluid into the needle or epidural catheter had been observed, post-dural puncture headache was diagnosed. The postpartum persistence of symptoms and the patient's generally worsening condition indicated the need for more thorough physical examination, which revealed signs of neurological involvement. Those findings and imaging studies (computed tomography of the brain, transcranial Doppler and magnetic resonance angiography) established a final diagnosis of postpartum cerebral angiopathy. Although epidural analgesia is increasingly requested by women entering labor, it is not a risk-free procedure. We describe a relatively unknown clinical entity, postpartum cerebral angiopathy, that developed during epidural analgesia for labor and that was initially believed to be a complication of the analgesic technique.
Monsma
M
M
Servicio de Anestesiología-Reanimación, Pabellón Maternal, Hospital Universitario La Fe de Valencia. mariamonsma@hotmail.com
Gallego
J
J
Lorente
P
P
Estévez
A
A
Villalaín
C
C
Bustos
M
M
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy
Cefalea por angiopatía cerebral durante el trabajo de parto con analgesia epidural.