Headache after dural puncture subarachnoid hemorrhage posing as meningitis

Nishant Sahay; Mamta Bara; Umesh K. Bhadani; Pallavi Singh

doi:10.18203/2349-2902.isj20173906

Authors

Nishant Sahay Department of anesthesia, AIIMS, Phulwarisharif, Patna- 801505, Bihar, India
Mamta Bara Department of anesthesia, AIIMS, Phulwarisharif, Patna- 801505, Bihar, India
Umesh K. Bhadani Department of anesthesia, AIIMS, Phulwarisharif, Patna- 801505, Bihar, India
Pallavi Singh Department of anesthesia, AIIMS, Phulwarisharif, Patna- 801505, Bihar, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173906

Keywords:

Meningitis, Post dural puncture headache, Precipitating factors

Abstract

Headache after neuraxial blocks is a common complication. This case discussion highlights an important diagnostic dilemma when a sentinel subarachnoid hemorrhage mimics meningitis after spinal anesthesia. A patient presented with features of meningismus after spinal anesthesia. To confirm diagnosis, a second dural tap was done which resulted in a frank sub-arachnoid hemorrhage. This correspondence highlight importance of early vascular imaging when a patient presents with atypical headache after a dural puncture.

Metrics

Metrics Loading ...

References

Reamy BV. Post-epidural headache: how late can it occur? J Am Board Fam Med. 2009;22:202-5.

Turnbull DK, Shepherd DB. "Post‐dural puncture headache: pathogenesis, prevention and treatment." British J Anaesthesia. 2003;91(5):718-29.

Saleem MA, Macdonald RL. Cerebral aneurysm presenting with aseptic meningitis: a case report. J Medical Case Reports. 2013;7(1):244.

Acharya, R. "Chronic subdural haematoma complicating spinal anaesthesia." Neurological Sci. 2005;25(6):348-50.

Mashour GA, Schwamm LH, Leffert L. Intracranial subdural hematomas and cerebral herniation after labor epidural with no evidence of dural puncture. J Am Society Anesthesiologists. 2006;104(3):610-2.