#36212 Post-puncture headache recurrence (pphr) after a blood patch – a clinical case

• DOI: 10.1136/rapm-2023-esra.458
• Publication Date: 2023-10-10T10:32:09Z
• Authors: Sara Fernandes; Mariana Pascoal; Margarida Gil; Piedade Gomes; Ana Almeida
• Keywords: Epidural Blood Patch; Post-dural-puncture headache; Perforation; Conservative Treatment

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> Post-Puncture Headache Recurrence (PPHR) is a complication performing neuraxial techniques. Performing blood patch recognized treatment with high success rate, however, recurrence headaches after it described. <h3>Methods</h3> Clinical case: 33 years pregnant. Admitted induction labor. An epidural block was performed labor analgesia, which complicated accidental perforation dura mater Touhy needle. Six hours delivery, headache typical PPHR started, so conservative instituted. Due to lack symptoms improvement, sphenopalatine carried out no symptomatic improvement. For reason, decided upon, resulting in complete resolution patient discharged following day. That night, she returned hospital due relapse severe headache. After discussing case Neurology specialist, Magnetic Resonance Imaging showed signs cerebral spine fluid hypotension. Conservative decided. The 4 days later partial improvement her condition. <h3>Results</h3> risks benefits new must be weighed. Before starting PPHR, necessary make differential diagnosis other causes puerperium