Dexamethasone Increases the Frequency of Post-Dural Puncture Headache (PDPH): An Evidence Based Reality Fardin Yousefshahi Department of Anesthesia and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Corresponding author: Fardin Yousefshahi, Department of Anesthesia and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Ira...

Inadvertent subarachnoid injection of a local anesthetic during the conduct of epidural anesthesia may have a devastating effect on the patient. The incidence of dural puncture with an epidural catheter has been reported to range from 0.5% to 0.9%. This case report demonstrates that, despite negative aspiration of cerebral spinal fluid from the catheter, subarachoid injection of a local anesthe...

Pneumocephalus is a rare consequence of epidural anesthesia, which may occur following inadvertent or unidentified dural puncture when the loss of resistance to air technique is applied to identify the epidural space. Headache is the most common symptom presented in this condition, usually with sudden onset. This case report describes an unusual presentation of diffuse pneumocephalus after an u...

An extremely rare case of congenital dural fibrosarcoma is reported in a 2 months old child who presented with scalp swelling since birth. CT scan revealed an osteolytic lesion compressing the underlying atrophic brain. Tumour was completely excised and duroplasty was done with a patch graft. Postoperative CSF leak was managed with aspirations and lumbar puncture.

The developments of new spinal needles and needle tip designs have reduced the incidence of postdural puncture headache (PDPH). Although it is clear that reducing the loss of CSF leak from dural puncture reduces the headache, there are areas regarding the pathogenesis, treatment, and prevention of PDPH that remain controversial. Air travel by itself may impose physiological alteration in centra...

Pneumocephalus following Ventriculoperitoneal (VP) shunt is an exceptionally rare entity. We report such event after an attempt of ventricular puncture (ventriculostomy) for VP shunt and then discuss the management of the same. The dry tap can lead to multiple attempts for ventriculostomy with added risk of complications. It can add dilemma as to what the subsequent management would be.There is...

Headache is a potential complication of epidural injection. We report a patient who developed headache 5 days after a lumbar epidural steroid injection, which was not related to the epidural procedure, but caused by Duloxetine induced hyponatremia. Antidepressant drug induced headache should be considered in the differential diagnosis of post dural puncture headache.

Normal saline or air is used to identify loss of resistance during identification of the epidural space for combined spinal-epidural analgesia. Following epidural needle placement using air for loss of resistance, up to 80% of parturients move, grimace, vocalise or experience paraesthesia or dysaesthesia during subsequent dural puncture by a spinal needle. We compared the effects of saline vers...

THE formation of cranial subdural hematomas after lumbar puncture is a well-known complication of spinal anesthesia, although rare in young patients. Pathogenesis of this condition has been related to rupture of bridging veins joining the cerebral surface and the dura mater. The precipitating event in these cases is the continuous leakage of cerebrospinal fluid through the dural hole. More unus...