title: [Management of transient radicular pain after receiving an epidural blood patch for headaches due to spontaneous intracranial hypotension].
abstract: Spontaneous intracranial hypotension headache is an uncommon disease that resolves spontaneously in most of the cases and in a short period of time. The initial treatment should be symptomatic. In some patients the symptomatology is extremely disabling, and in these cases both the diagnosis and treatment may be performed by an epidural blood patch. A 49-year-old Caucasian woman, with no previous record of epidural or intrathecal puncture, consulted in the Emergency Department complaining of a 9-day history of frontal headache and diplopia, along with nausea and vomiting. The patient was diagnosed with spontaneous intracranial hypotension headache. Considering the symptomatology and the uncontrolled pain, the Pain Unit of our hospital performed an epidural blood patch. In the first 24h the patient reported a remarkable relief of both headache and diplopia but developed a left lumbar radiculopathy that was treated successfully with supportive measures. Transient lumbar radiculopathy is a common and acceptable event secondary to the use of epidural blood patch as a treatment for spontaneous intracranial hypotension headache.
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España. Electronic address: mmelo@santpau.cat.
authors.forename: M C
authors.initials: MC
authors.lastname: Melo
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: M E
authors.initials: ME
authors.lastname: Revuelta
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: T
authors.initials: T
authors.lastname: Santeularia
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Genové
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Català
mesh_terms: D020434:Abducens Nerve Diseases / Q000209:etiology / Q000628:therapy; D001416:Back Pain / Q000209:etiology*; D017217:Blood Patch, Epidural / Q000009:adverse effects*; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications*; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D013126:Spinal Nerve Roots
keywords: Cefalea; Epidural blood patch; Headache; Hipotensión intracraneal espontánea; Parche hemático epidural; Spontaneous intracranial hypotension