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Intraventricular hemorrhage after epidural blood patching: an unusual complication.

Sorour M, Krisht KM, Couldwell WT - Case Rep Neurol Med (2014)

Bottom Line: The second patient, a 29-year-old woman, was found to have nontraumatic IVH three days after undergoing an EBP.This highlights a potential sequel of EBP that may be observed on CT scan of the head.In the event that IVH is detected, signs and symptoms of hydrocephalus should be closely monitored with the consideration for a future workup if warranted by the clinical picture.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT 84132, USA.

ABSTRACT
The authors present two cases of intraventricular hemorrhage (IVH) believed to be a result of epidural blood patching. The first was a 71-year-old woman who had new onset of nontraumatic IVH on computed tomography (CT) scan after undergoing an epidural blood patch (EBP). This amount of intraventricular blood was deemed an incidental finding since it was of very small volume to account for her overall symptoms. The second patient, a 29-year-old woman, was found to have nontraumatic IVH three days after undergoing an EBP. This was seen on CT scan of the head for workup of pressure-like headaches, nausea, vomiting, and absence seizures. Conservative management was followed in both instances. Serial CT scan of the head in our first patient displayed complete resolution of her IVH. The second patient did not have follow-up CT scans because her overall clinical picture had improved significantly. This highlights a potential sequel of EBP that may be observed on CT scan of the head. In the event that IVH is detected, signs and symptoms of hydrocephalus should be closely monitored with the consideration for a future workup if warranted by the clinical picture.

No MeSH data available.


Related in: MedlinePlus

Noncontrast axial computed tomography scan of the head done 3 days after epidural blood patch showing a small amount of blood layering the occipital horns of both lateral ventricles.
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fig2: Noncontrast axial computed tomography scan of the head done 3 days after epidural blood patch showing a small amount of blood layering the occipital horns of both lateral ventricles.

Mentions: Three days later, she developed new-onset, pressure-like, nonpositional headaches associated with episodes of staring into space, vomiting, and blurry vision lasting for 5–10 minutes and associated with right gaze deviation followed by confusion and restlessness. A noncontrast CT scan showed a small amount of IVH layering in her occipital horns along with small subarachnoid hemorrhage (SAH) adjacent to the right vertex (Figure 2). Her coagulation profile was normal (INR = 1.0, PTT = 27 s). She was started on levetiracetam (500 mg twice daily) for her seizures. She underwent long-term surface electroencephalogram monitoring with resolution of her seizure activity and clinical improvement. Because the volume of blood was minimal and her clinical status had improved, the patient did not undergo follow-up CT scans to document resolution of her IVH.


Intraventricular hemorrhage after epidural blood patching: an unusual complication.

Sorour M, Krisht KM, Couldwell WT - Case Rep Neurol Med (2014)

Noncontrast axial computed tomography scan of the head done 3 days after epidural blood patch showing a small amount of blood layering the occipital horns of both lateral ventricles.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4273463&req=5

fig2: Noncontrast axial computed tomography scan of the head done 3 days after epidural blood patch showing a small amount of blood layering the occipital horns of both lateral ventricles.
Mentions: Three days later, she developed new-onset, pressure-like, nonpositional headaches associated with episodes of staring into space, vomiting, and blurry vision lasting for 5–10 minutes and associated with right gaze deviation followed by confusion and restlessness. A noncontrast CT scan showed a small amount of IVH layering in her occipital horns along with small subarachnoid hemorrhage (SAH) adjacent to the right vertex (Figure 2). Her coagulation profile was normal (INR = 1.0, PTT = 27 s). She was started on levetiracetam (500 mg twice daily) for her seizures. She underwent long-term surface electroencephalogram monitoring with resolution of her seizure activity and clinical improvement. Because the volume of blood was minimal and her clinical status had improved, the patient did not undergo follow-up CT scans to document resolution of her IVH.

Bottom Line: The second patient, a 29-year-old woman, was found to have nontraumatic IVH three days after undergoing an EBP.This highlights a potential sequel of EBP that may be observed on CT scan of the head.In the event that IVH is detected, signs and symptoms of hydrocephalus should be closely monitored with the consideration for a future workup if warranted by the clinical picture.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT 84132, USA.

ABSTRACT
The authors present two cases of intraventricular hemorrhage (IVH) believed to be a result of epidural blood patching. The first was a 71-year-old woman who had new onset of nontraumatic IVH on computed tomography (CT) scan after undergoing an epidural blood patch (EBP). This amount of intraventricular blood was deemed an incidental finding since it was of very small volume to account for her overall symptoms. The second patient, a 29-year-old woman, was found to have nontraumatic IVH three days after undergoing an EBP. This was seen on CT scan of the head for workup of pressure-like headaches, nausea, vomiting, and absence seizures. Conservative management was followed in both instances. Serial CT scan of the head in our first patient displayed complete resolution of her IVH. The second patient did not have follow-up CT scans because her overall clinical picture had improved significantly. This highlights a potential sequel of EBP that may be observed on CT scan of the head. In the event that IVH is detected, signs and symptoms of hydrocephalus should be closely monitored with the consideration for a future workup if warranted by the clinical picture.

No MeSH data available.


Related in: MedlinePlus