CASE REPORT Two cases are presented in which the complication of dural puncture is documented in the context of a lumbar transforaminal epidural steroid injection. The hazard of dural puncture during transforaminal epidural injections, the anatomy of the dural and thecal sac, the potential for subdural injections, and relevant literature are reviewed. DESIGN Report of two cases. BACKGROUND ...

To the Editor:— We read with interest the study by Scavone et al. that demonstrates the absence of efficacy of a prophylactic epidural blood patch after inadvertent dural puncture. We suggest that two factors could have influenced the negative result of this trial. First, inadvertent dural puncture could have been overdiagnosed, namely when loss of resistance to saline was used to locate epidur...

It is well known that symptoms of post-dural puncture headache (PDPH) are more likely if there has been a preceding PDPH. We herein present a patient who developed a PDPH following each of two dural punctures separated by 9 years.

In the 1950's, the generally accepted theory for the development of post dural puncture headache (PDPH) was leakage of cerebrospinal fluid via the hole in the dura which led to the introduction of smaller sized needles for dural puncture. This has lowered but not eliminated the incidence of PDPH. The literature has virtually as many different statistics on the incidence of PDPH as there are aut...

PURPOSE Bilateral sixth nerve palsy is a known though uncommon complication following dural puncture. The recommended treatment consists of hydration and alternate monocular occlusion. The value and the timing of an epidural blood patch (EBP) for sixth nerve palsy remains controversial as some authors have demonstrated benefits in performing an EBP early in course of the nerve palsy whereas oth...

Epidural block is useful for chronic pain and thoracic surgery. However, there are several complications, which include vessels or dural puncture, pleural puncture, misplacement of epidural catheter and trauma to the spinal cord. We report a case of intercostal misplacement of an epidural catheter in a 66-year-old patient who scheduled for left thoracotomy.

Post-dural puncture headaches (PDPHs) present an important clinical problem. We assessed methods to decrease accidental dural punctures (ADPs) and interventions to reduce PDPH following ADP. Multiple electronic databases were searched for randomised clinical trials (RCTs) of parturients having labour epidurals, in which the studied intervention could plausibly affect ADP or PDPH, and the incide...

Neuraxial analgesia in the form of an epidural or combined spinal is most common and popular technique used to control pain associated with labor vaginal delivery. has many advantages but also carry some inherent risk it.