A Rare Case of Transverse Sinus Venous Thrombosis Simulating Postdural Puncture Headache After Cervical Epidural Injection.
Postdural puncture headache (PDPH) is a feared complication related to epidural steroid injections. We report a unique case in which all subjective and objective findings indicated the diagnosis of PDPH. However, the patient failed appropriate conservative and interventional management. Therapeutic failure prompted further investigation to establish the correct diagnosis of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare, difficult to diagnose, but potentially lethal disorder with nonspecific and variable clinical presentations, including headache and focal neurological deficits. Performing magnetic resonance imaging and magnetic resonance venogram should be considered early, especially in patients who fail to respond to standard interventions for PDPH.
From the *Department of Pain Management, Ochsner Clinic Foundation, New Orleans, Louisiana; and †Department of Pain Management, Anesthesiology Institute, Cleveland Clinic Foundation, New Orleans, Louisiana.
Maged
M
Guirguis
Eduardo
E
Jusino
Reda
R
Tolba
Samuel
S
Samuel
D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*; D020227:Lateral Sinus Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D051299:Post-Dural Puncture Headache / Q000000981:diagnostic imaging* / Q000209:etiology; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology