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Canadian Journal of Anesthesia, Vol 42, 221-223, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Post-dural puncture thoracic pain without headache: relief with epidural blood patch

SA Dunbar and NP Katz
Department of Anesthesia and Pain Clinic, Brigham and Women's Hospital, Boston, USA.

We report two unusual cases of postural, post-dural puncture upper thoracic interscapular backache, without headache, that were relieved by epidural blood patching. There is controversy concerning the aetiology of headache associated with the post-dural puncture syndrome. Mechanisms previously proposed have included traction on pain-sensitive intracranial structures such as the dura or blood vessels, or a vascular mechanism which may be adenosine-receptor mediated. These two cases suggest that traction on cervical or upper thoracic nerve roots should be considered as a possible mechanism of pain in the post-dural puncture syndrome.


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D. K. Turnbull and D. B. Shepherd
Post-dural puncture headache: pathogenesis, prevention and treatment
Br. J. Anaesth., November 1, 2003; 91(5): 718 - 729.
[Abstract] [Full Text] [PDF]


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Copyright © 1995 by the Canadian Anesthesiologists' Society.