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- S A Dunbar and N P Katz.
- Department of Anesthesia and Pain Clinic, Brigham and Women's Hospital, Boston, USA.
- Can J Anaesth. 1995 Mar 1;42(3):221-3.
AbstractWe report two unusual cases of postural, post-dural puncture upper thoracic interscapular backache, without headache, that were relieved by epidural blood patching. There is controversy concerning the aetiology of headache associated with the post-dural puncture syndrome. Mechanisms previously proposed have included traction on pain-sensitive intracranial structures such as the dura or blood vessels, or a vascular mechanism which may be adenosine-receptor mediated. These two cases suggest that traction on cervical or upper thoracic nerve roots should be considered as a possible mechanism of pain in the post-dural puncture syndrome.
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