Post-dural puncture headache and posterior reversible encephalopathy syndrome: a misdiagnosis or co-presentation?
Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition associated with a variety of underlying conditions, including preeclampsia. The headache associated with PRES may be indistinguishable from post-dural puncture headache, which may result in diagnostic delay. We report a case of PRES that was initially diagnosed as post-dural puncture headache. The case was unique because there were no features of preeclampsia, initial presentation was typical of post-dural puncture headache, and there was a five-day interval between the onset of headache and the development of seizures and cortical blindness, pathognomonic of PRES. It remains unclear whether this was an atypical presentation of PRES, initially misdiagnosed as post-dural puncture headache, or whether delayed treatment of headache triggered PRES.
Department of Anaesthesia, Hull Royal Infirmary, Hull, UK. Electronic address: h.r.doherty@gmail.com.
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Doherty
Department of Anaesthesia, Hull Royal Infirmary, Hull, UK.
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Hameed
Department of Anaesthesia, Hull Royal Infirmary, Hull, UK.
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Ahmed
Department of Anaesthesia, Hull Royal Infirmary, Hull, UK.
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Russell
D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D051299:Post-Dural Puncture Headache / Q000150:complications / Q000175:diagnosis*; D054038:Posterior Leukoencephalopathy Syndrome / Q000150:complications / Q000175:diagnosis*; D012640:Seizures / Q000209:etiology; D055815:Young Adult
Post-dural puncture headache; Posterior reversible encephalopathy syndrome; Postpartum headache