TY - JOUR
T1 - Intracranial hypotension and PRES
T2 - Case report
AU - Pugliese, Silvia
AU - Finocchi, V.
AU - Borgia, M. L.
AU - Nania, C.
AU - Della Vella, B.
AU - Pierallini, A.
AU - Bozzao, A.
PY - 2010/10
Y1 - 2010/10
N2 - We report a case of a woman presenting, 7 days after epidural analgesia for a caesarean section, to the emergency room for a worsening of the headache and tonico-clonic seizures. MRI showed alterations suggestive of the presence of intracranial hypotension (IH) as well as evidence of posterior reversible encephalopathy syndrome (PRES). She was treated with a blood patch which leads to the prompt regression of the clinical symptoms and follow-up MRI, after 15 days, showed complete resolution of radiological alterations. The possible pathogenetic relationship between IH, secondary to the inadvertent dural puncture, and PRES is discussed. We suggest that venous stagnation and hydrostatic edema, secondary to intracranial hypotension, probably played a crucial role in the pathogenesis of PRES.
AB - We report a case of a woman presenting, 7 days after epidural analgesia for a caesarean section, to the emergency room for a worsening of the headache and tonico-clonic seizures. MRI showed alterations suggestive of the presence of intracranial hypotension (IH) as well as evidence of posterior reversible encephalopathy syndrome (PRES). She was treated with a blood patch which leads to the prompt regression of the clinical symptoms and follow-up MRI, after 15 days, showed complete resolution of radiological alterations. The possible pathogenetic relationship between IH, secondary to the inadvertent dural puncture, and PRES is discussed. We suggest that venous stagnation and hydrostatic edema, secondary to intracranial hypotension, probably played a crucial role in the pathogenesis of PRES.
KW - Epidural analgesia
KW - Headache
KW - Intracranial hypotension
KW - MRI
KW - PRES
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U2 - 10.1007/s10194-010-0226-z
DO - 10.1007/s10194-010-0226-z
M3 - Article
C2 - 20517704
AN - SCOPUS:78049285732
VL - 11
SP - 437
EP - 440
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
SN - 1129-2369
IS - 5
ER -