Postural headache in the presence of cerebral venous sinus thrombosis.
Cerebral venous sinus thrombosis (CVST) can present with a headache similar to that after a dural puncture. We report on a patient who developed postural headache after epidural anesthesia for delivery. The headache became more intense during the following 6 days, and the patient had a tonic clonic seizure. A magnetic resonance angiogram demonstrated CSVT, and anticoagulation therapy was started, with resolution of the symptoms over 2 wk. Any postdural-puncture headache that loses its positional character, becomes persistent, or does not improve with a properly performed blood patch should raise the suspicion of CVST.
Todorov
Ludmil
L
Department of Anesthesiology, University of Illinois at Chicago.
Laurito
Charles E
CE
Schwartz
David E
DE
D000328:Adult; D005260:Female; D006801:Humans; D051299:Post-Dural Puncture Headache / Q000150:complications*; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000209:etiology