JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Arai, M.
Right arrow Articles by Terada, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Arai, M.
Right arrow Articles by Terada, H.
Related Collections
Right arrow Complications
Right arrow Regional Anesthesia

Anesth Analg 2006;102:1865-1866
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000217117.77826.dd

REGIONAL ANESTHESIA

Divergence Paresis Without Positional Headache: An Unusual Presentation of Cerebrospinal Fluid Hypovolemia After Spinal Anesthesia

Motomi Arai, MD, PhD, Satoko Matsushima, MD, and Hiroshi Terada, MD

Departments of Neurology and Ophthalmology, Seirei Mikatahara General Hospital; Choseido Terada Clinic, Hamamatsu, Japan.

Address correspondence and reprint requests to Motomi Arai, MD, Department of Neurology, Seirei Mikatahara General Hospital, Mikatahara-cho 3453, Hamamatsu, Shizuoka 433-8558, Japan. Address e-mail to arai-m{at}sis.seirei.or.jp.

We report a rare complication of spinal anesthesia—divergence paresis—which is characterized by an acquired horizontal diplopia at distance without evidence for abducens palsy. A 64-yr-old man underwent prostatectomy under spinal anesthesia with 2.5 mL of dibucaine hydrochloride 0.3% injected through a 20-gauge cutting-tip spinal needle. Seventeen days after the operation, the patient noticed horizontal diplopia for distant objects. Although cranial magnetic resonance imaging demonstrated diffuse pachymeningeal gadolinium enhancement and subdural effusion, characteristic findings of cerebrospinal fluid hypovolemia, the patient had no positional headache. Gadolinium-enhanced magnetic resonance imaging may be useful when a patient develops neurologic symptoms after dural puncture.






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