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Spinal Anestezi Girişimine Bağlı Baş Ağrısı Olduğu Düşünülen Bir Hastada Serebral Venöz Tromboz

Year 2014, Volume: 5 Issue: 5, 151 - 154, 01.05.2014

Abstract

Giriş: Spinal anestezi sonrası başağrısı, sıklıkla karşılaşılan bir
komplikasyondur. Başağrısı oluşum mekanizması, meningeal
zedelenme sonrası ortaya çıkan beyin omurilik sıvısında kaçağa
bağlı intrakranial hipotansiyondur. Ortaya çıkan ağrı tipik olarak
ortostatik özelliktedir. Serebral venöz tromboz nadir görülen bir
hastalıktır. Kliniğinde en sık görülen semptom başağrısıdır. İzlenen
ağrı farklı karakteristik özelliklerle karşımıza çıkabilmektedir.
Olgu Sunumu: Sunulan olguda, spinal anestezi sonrasında
ortaya çıkan ve tedaviye dirençli başağrısı yakınması mevcuttur.
Hasta, değişik zamanlarda birçok kez acil servislere başvurmuş
ve başağrısı şikayeti spinal anesteziye bağlanarak bu yönde
tedavi verilmiştir. Ancak incelemelerimiz sonrasında başağrısının,
serebral venöz trombozdan kaynaklandığı tespit edilmiştir.
Sonuç: Spinal girişim anamnezi olan kişilerde ortaya çıkan
başağrısının, öncelikle intrakranial hipotansiyona sekonder
olduğu akla gelebilmektedir. Sunulan olguda görüldüğü gibi,
spinal anestezi ile ilişkili başağrısındaki ortostatik özelliğin
kaybolması ve ağrıda progresyon ortaya çıkması gibi bulgularda
başağrısının ikincil nedenlerinin araştırılması gerekmektedir.

References

  • Franksson C, Gordt T. Headache after spinal anaesthesia and a technique for lessening its frequency. Acta Chir Scand 1946; 94: 443-54.
  • Peters KS. Secondary headache and head pain emergencies. Prim Care. 2004; 31: 381-93. [CrossRef]
  • de Bruljin SF, Stam J, Kampelle U. Thunderclap headache as first symptom of cerebral venous sinus thrombosis. For the CVST Study Group. Lancet 1996; 348: 1623-5. [CrossRef]
  • de Bruijn SF1, de Haan RJ, Stam J. Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients. J Neurol Neurosurg Psychiatry 2001; 70: 105-8. [CrossRef]
  • Stam J. Trombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352: 1791-8. [CrossRef]
  • Siegle JH, Dewan DM, James FM 3rd. Cerebral infarction following spinal anesthesia for cesarean section. Anesth Analg 1982; 61: 390-2. [CrossRef]
  • Einhaupl K, Stam J, Bousser MG, De Bruijn SF, Ferro JM, Martinelli I, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol 2010; 17: 1229-35. [CrossRef]
  • Silberstein SD, Lipton RB, Goadsby PJ. Headache in Clinical Practice. Second edition. Editörler Türkçe Çeviri: Ertaş M, Akman-Demir G. Klinik Uygulamada Başağrısı. İkinci baskı, Yelkovan Yayıncılık, İstanbul, 2004.
  • T Kansu, S İnci. Spontaneous Intracranial Hypotension without Orthostatic Headache. Türk Nörol Derg. 2009; 15: 35-8.
  • Berroir S, Grabli D, Heran F, Bakouche P, Bousser MG. Cerebral venous sinus thrombosis in two patients with spontaneous intracranial hypotension. Cerebrovasc Dis 2004; 17: 9-12. [CrossRef]

Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention

Year 2014, Volume: 5 Issue: 5, 151 - 154, 01.05.2014

Abstract

Introduction: Headache after spinal anesthesia is a frequently seen complication. The mechanism of headache is intracranial hypotension due to cerebrospinal fluid leaking after meningeal traumatization. The headache is typically orthostatic. Cerebral venous thrombosis is a rare disease. The most common clinical symptom is headache. Headache can appear with different characteristic features.Case Report: In the presented case, there was headache that was resistant to treatment and occurred after spinal anesthesia. The patient applied to the emergency service several times, and her complaint was thought to be associated with spinal anesthesia, and she was given treatment in that direction. But, after some scanning and laboratory tests and physical examinations we made, we found that the headache originated from cerebral venous thrombosis.Conclusion: Headache in a patient with previous spinal anesthesia history can be regarded as secondary to intracranial hypotension. But, as seen in the presented case, other reasons should be investigated if there is progression in the headache and orthostatic of spinal anesthesia associated headache disappears

References

  • Franksson C, Gordt T. Headache after spinal anaesthesia and a technique for lessening its frequency. Acta Chir Scand 1946; 94: 443-54.
  • Peters KS. Secondary headache and head pain emergencies. Prim Care. 2004; 31: 381-93. [CrossRef]
  • de Bruljin SF, Stam J, Kampelle U. Thunderclap headache as first symptom of cerebral venous sinus thrombosis. For the CVST Study Group. Lancet 1996; 348: 1623-5. [CrossRef]
  • de Bruijn SF1, de Haan RJ, Stam J. Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients. J Neurol Neurosurg Psychiatry 2001; 70: 105-8. [CrossRef]
  • Stam J. Trombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352: 1791-8. [CrossRef]
  • Siegle JH, Dewan DM, James FM 3rd. Cerebral infarction following spinal anesthesia for cesarean section. Anesth Analg 1982; 61: 390-2. [CrossRef]
  • Einhaupl K, Stam J, Bousser MG, De Bruijn SF, Ferro JM, Martinelli I, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol 2010; 17: 1229-35. [CrossRef]
  • Silberstein SD, Lipton RB, Goadsby PJ. Headache in Clinical Practice. Second edition. Editörler Türkçe Çeviri: Ertaş M, Akman-Demir G. Klinik Uygulamada Başağrısı. İkinci baskı, Yelkovan Yayıncılık, İstanbul, 2004.
  • T Kansu, S İnci. Spontaneous Intracranial Hypotension without Orthostatic Headache. Türk Nörol Derg. 2009; 15: 35-8.
  • Berroir S, Grabli D, Heran F, Bakouche P, Bousser MG. Cerebral venous sinus thrombosis in two patients with spontaneous intracranial hypotension. Cerebrovasc Dis 2004; 17: 9-12. [CrossRef]
There are 10 citations in total.

Details

Other ID JA63HS43TM
Journal Section Case Report
Authors

Fatma Doğanay This is me

Ferudun Koyuncu This is me

Publication Date May 1, 2014
Submission Date May 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 5

Cite

APA Doğanay, F., & Koyuncu, F. (2014). Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention. Journal of Emergency Medicine Case Reports, 5(5), 151-154.
AMA Doğanay F, Koyuncu F. Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention. Journal of Emergency Medicine Case Reports. May 2014;5(5):151-154.
Chicago Doğanay, Fatma, and Ferudun Koyuncu. “Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention”. Journal of Emergency Medicine Case Reports 5, no. 5 (May 2014): 151-54.
EndNote Doğanay F, Koyuncu F (May 1, 2014) Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention. Journal of Emergency Medicine Case Reports 5 5 151–154.
IEEE F. Doğanay and F. Koyuncu, “Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention”, Journal of Emergency Medicine Case Reports, vol. 5, no. 5, pp. 151–154, 2014.
ISNAD Doğanay, Fatma - Koyuncu, Ferudun. “Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention”. Journal of Emergency Medicine Case Reports 5/5 (May 2014), 151-154.
JAMA Doğanay F, Koyuncu F. Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention. Journal of Emergency Medicine Case Reports. 2014;5:151–154.
MLA Doğanay, Fatma and Ferudun Koyuncu. “Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention”. Journal of Emergency Medicine Case Reports, vol. 5, no. 5, 2014, pp. 151-4.
Vancouver Doğanay F, Koyuncu F. Cerebral Venous Thrombosis in a Patient Who Is Regarded to Have Headache Due to Spinal Anesthetic Intervention. Journal of Emergency Medicine Case Reports. 2014;5(5):151-4.