Year : 2022  |  Volume : 16  |  Issue : 1  |  Page : 114-116

Spontaneous intracranial hypotension following spinal anesthesia initially misdiagnosed as postdural puncture headache

Department of Anesthesia and Pain Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea

Correspondence Address:
Daeseok Oh
875, Haeun-daero, Haeundae-gu, Busan, 612-896
Republic of Korea
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_538_21

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Spontaneous intracranial hypotension (SIH) is not rare, but its diagnosis remains challenging. SIH tends to be misdiagnosed as postdural puncture headache when orthostatic headache develops subsequent to spinal anesthesia because both have similar symptoms. We report the case of a 35-year-old man with orthostatic headache following spinal anesthesia, who did not respond to conventional therapy for postdural puncture headache. SIH was confirmed after epidural fluid collection was identified at the thoracic spine level on magnetic resonance myelography. Physicians must consider SIH despite a history of neuraxial block. Diagnostic work-up is necessary to identify potential cerebrospinal fluid leakage in refractory cases.

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