Akın Suna TAKMAZ, Ayşe Günay KAYA, Solmaz GÜNAL, Nurşen GÜRSOY, Hülya BAŞAR

Spinal anestezi sonrası serviko-torakal ağrı

Spinal anestezi sonrası dura zedelenmesine bağlı olarak gelişen baş ağrısı, klasik olarak frontal, oksipital bölgede görülen, dik pozisyonda artıp supin pozisyonda azalan veya tamamen kaybolan, postural bir ağrıdır. Burada, spinal anestezi sonrası, baş ağrısı olmaksızın, üst torakal ve alt servikal bölgede postürel karakterde ağrı ile kendini gösteren bir olgu sunulmuştur.

Anahtar Kelimeler:

Dural ponksiyon sonrası baş ağrısı, Erişkin, Anestezi, spinal, Manyetik rezonans görüntüleme

Cervicothoracic pain after spinal anesthesia

Headache caused by duramater injury after spinal anesthesia is a postural pain which is clasically seen on frontal and occipital area and increases with straight position and decreases or loses with supine position. In this article, a case with postural pain in upper thorocal and lower servical area, without headache, after spinal anesthesia is discussed.

Keywords:

Post-Dural Puncture Headache, Adult, Anesthesia, Spinal, Magnetic Resonance Imaging,

PDF

___

1. Lybecker H, Djernes M, Schmidt JF. Post-dural puncture headache (PDPH): onset, duration, severity, and associated symptomes. Acta Anaesthesiol Scand 1995; 39: 605-612.
2. Pannullo SC, Reich JB, Krol G, Deck MDF, Possner JB. MRI changes in intracranial hypotension. Neurology 1993; 43: 919-926.
3. Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psych 1991; 54: 440–442.
4. Turnbull DK and Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and teatment. Br J Anaesth 2003; 91: 718-729.
5. Mc Grady EM, Freshwater JV. Spinal headache with no headache. Anaesthesia 1991; 46: 794.
6. Dunbar SA, Katz N,P. Post-dural puncture thoracic pain without headache: relief with epidural blood patch. Can J Anaesth 1995;42:3:221-223.
7. Schabel JE, Wang E, Glass PSA. Arm Pain as an unusual presentation of postdural puncture intracranial hypotension. Anest Analg 2000; 91: 910-912.
8. Errando CL, Peiro CM. Postdural puncture upper back pain as an atypical presentation of postdural puncture symptoms. Anesthesiology 2002; 96(4): 1019-1020
9. Gaiser R. Postdural puncture headache. Curr Opin Anaesthesiol 2006; 19: 249–253.
10. Cornwall RD, Dolan WM. Case history: Complications following epidural "blood patch" for postlumbar-puncture headache. Anesth Analg 1973; 52: 67–72.
11.Tekkok IH, Carter DA, Brinker R. Spinal subdural haematoma as a complication of immediate epidural blood patch. Can J Anesth 1996; 43: 306–309.
12. Reynolds AF, Hameroff SR, Blitt CD, Roberts WL. Spinal subdural epiarachnoid hematoma: A complication of a novel epidural blood patch technique. Anesth Analg 1980; 59: 702–703.
13. Aldrete JA, Brown TL. Intrathecal hematoma and arachnoiditis after prophylactic blood patch through a catheter. Anesth Analg 1997; 84: 233–234.
14. Sperry RJ, Gartrell A, Johnson JO. Epidural blood patch can cause acute neurologic deterioration. Anesthesiology 1995; 82: 303–305.
15. Beers RA, Cambareri JJ, Rodziewicz GS. Acute deterioration of mental status following epidural blood patch. Anesth Analg 1993; 76: 1147–1149.
16. Willner D, Weissman C, Shamir M Y. Chronic Back Pain Secondary to a Calcified Epidural Blood Patch. Anesthesiology 2008; 108: 535–537.
17. Vilming ST, Kloster R, Sandvik L. When should an epidural blood patch be performed in postlumbar puncture headache? A theoretical approach based on a cohort of 79 patients. Cephalalgia 2005; 25: 523–527.
18. Loeser EA, Hill GE, Bennett GM, et al. Time vs success rate for epidural blood patch. Anesthesiology 1978; 49: 147–148.