Postdural-puncture headache may be a sign of serious sequelae such as fatal brain herniation and should be treated promptly.
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Fatal uncal herniation may follow spinal anesthesia after postdural puncture headache; this Level 5 case leaves open whether prompt treatment alters rare outcomes.
Leakage of cerebrospinal fluid following dural puncture and subsequent downward sagging of the brain have been suggested as a cause of the rare subdural haematomas occurring after spinal or attempted epidural anaesthesia which have been reported in the literature. We report a case where this mechanism probably produced a fatal brain lesion, due to the herniation of the uncus against the tentorium cerebelli 15 days after spinal anaesthesia. The patients complained of severe headache and nausea after the procedure. The reported case shows that postdural-puncture headache may be a sign of more serious sequelae and should be treated by the means available.
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Eerola et al. (1981) studied this question.
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