title: Unusual presentation of postdural puncture headache requiring repeat epidural blood patch in a 4-year-old child.
abstract: We present the case of a 4-year-old child who required two epidural blood patches (EBPs) to treat a delayed onset postdural puncture headache (PDPH) caused by lumbar cerebrospinal fluid drain. The first EBP was unsuccessful with 0.41 ml·kg(-1) of blood injected. A second EBP with 0.76 ml·kg(-1) of blood was performed 2 days later with the complete resolution of symptoms. The volume of blood necessary for effective treatment for symptomatic cerebrospinal fluid leaks in children remains controversial, and a repeat EBP may be required for resolution of symptoms.
authors.affiliation: Department of Anesthesia, McMaster Children's Hospital/McMaster University, Hamilton, Canada.
authors.forename: Bruno C R
authors.initials: BC
authors.lastname: Borges
authors.forename: Gail
authors.initials: G
authors.lastname: Wong
authors.forename: Lisa
authors.initials: L
authors.lastname: Isaac
authors.forename: Jason
authors.initials: J
authors.lastname: Hayes
mesh_terms: D017217:Blood Patch, Epidural / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D051299:Post-Dural Puncture Headache / Q000209:etiology* / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D019233:Retreatment; D013129:Spinal Puncture / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: anesthesia; blood patch; epidural; pediatrics; postdural puncture headache; postoperative complications