Post-dural puncture headaches following spinal drain placement during thoracoabdominal aortic aneurysm repair: incidence, associated risk factors, and treatment

Journal of Anesthesia
Sean P RileyKristopher M Schroeder

Abstract

Spinal drains are used as a neuroprotective measure during thoracoabdominal aortic aneurysm (TAA) repair. Unfortunately, these drains can cause post-dural puncture headaches (PDPH). While PDPH following spinal anesthesia have been thoroughly evaluated, limited data exists about the incidence and risk factors for PDPH following spinal drains. Additionally, the efficacy of treatment with conservative therapies and epidural blood patches (EBP) for PDPH secondary to spinal drains has not been well documented. Data on 235 patients receiving spinal drains for scheduled TAA repair and surviving to discharge between January, 2005 and July, 2012 at the University of Wisconsin Hospitals and Clinics were retrospectively reviewed. The following data were extracted from the patient medical record: patient demographics, pre-existing medical conditions, spinal drain details, PDPH presentation, PDPH treatment methods, and success of treatments used. This data was then analyzed for statistical significance. Of 235 patients, 43 (18.3 %) developed PDPH. Younger age (p < 0.001) and history of preoperative headache (p ≤ 0.001) were found to increase the risk of PDPH. Use of EBP, either as the primary treatment, or following failed conservative ther...Continue Reading

References

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Citations

Feb 9, 2017·Journal of Neurosurgical Anesthesiology·Abhijit V LeleUNKNOWN Representing SNACC Task Force for Developing Guidelines for Perioperative Management of External Ventricular and Lumbar Drai

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