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Anesth Analg 2005;101:1499-1500
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000181003.37968.CB

NEUROSURGICAL ANESTHESIA

Postural Headache in the Presence of Cerebral Venous Sinus Thrombosis

Ludmil Todorov, MD, Charles E. Laurito, MD, and David E. Schwartz, MD

Department of Anesthesiology, University of Illinois at Chicago

Address correspondence and reprint requests to Ludmil Todorov, MD, Department of Anesthesiology, 1740 West Taylor St., suite 3200, Chicago, IL 60612. Address e-mail to ludmil{at}rocketmail.com.

Cerebral venous sinus thrombosis (CVST) can present with a headache similar to that after a dural puncture. We report on a patient who developed postural headache after epidural anesthesia for delivery. The headache became more intense during the following 6 days, and the patient had a tonic clonic seizure. A magnetic resonance angiogram demonstrated CSVT, and anticoagulation therapy was started, with resolution of the symptoms over 2 wk. Any postdural-puncture headache that loses its positional character, becomes persistent, or does not improve with a properly performed blood patch should raise the suspicion of CVST.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.