• J Clin Anesth · May 2017

    Case Reports

    A case of paradoxical presentation of a postural postdural puncture headache after combined spinal-epidural anesthesia.

    • John W Bordlee, Burton D Beakley, Rayomond Mody, Anne P McConville, Jonathan T Weed, Brian P McClure, Peter J Foldes, Jonathan G Ma, Alan D Kaye, and Jonathan P Eskander.
    • Department of Anesthesiology, Tulane School of Medicine, New Orleans, LA. Electronic address: jbordlee@tulane.edu.
    • J Clin Anesth. 2017 May 1; 38: 156-157.

    AbstractWe report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position. The patient was discharged from emergency department after an improvement following treatment with labetalol, ondansetron, ketorolac, and fluid resuscitation.Copyright © 2016. Published by Elsevier Inc.

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