• BMJ case reports · Jun 2013

    Case Reports

    Persistent headache in a postpartum patient: the investigation and management.

    • Korcan Aysun Gonen, Ozlem Taskapilioglu, Abdurrahim Dusak, and Bahattin Hakyemez.
    • Department of Radiology, Namik Kemal University, School of Medicine, Tekirdag, Turkey. aysunbalc@yahoo.com
    • BMJ Case Rep. 2013 Jun 21; 2013.

    AbstractPostdural puncture headache (PDPH) is the most common complication of obstetric regional anaesthesia and the most likely cause of headache in a woman who underwent epidural anaesthesia during delivery. Cerebral venous sinus thrombosis (CVST) is an uncommon cause of postpartum headache. Anaesthesia in obstetrics may lead to long-lasting intracranial hypotension resulting in CVST. CVST is a serious pathology with high mortality if misdiagnosed, but its correct and rapid diagnosis offers the opportunity for early treatment. Cranial magnetic resonance imaging (MRI) is an important modality in the diagnosis of both CVST and intracranial hypotension. The latter condition may be treated either by an epidural blood patch or bed rest and hydration. We report a case of a 36-year-old woman who developed CVST and multiple venous infarcts after an attempted epidural procedure during delivery. She was treated conservatively with bed rest, hydration and low-molecular-weight heparin and the patient recovered completely.

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