ABSTRACT
The Epidural blood patch is considered the gold standard for managing postdural puncture headache when supportive measures fail. However, it is a procedure which can lead to another inadvertent dural puncture. Other potential adverse events that could occur during a blood patch are meningitis, neurological deficits, and unconsciousness. The bilateral greater occipital nerve block has been used for treating chronic headaches in patients with PDPH with a single injection. This minimally invasive, simple procedure can be considered for patients early, along with other supportive treatment, and an epidural blood patch can be avoided.
Subject(s)
Humans , Blood Patch, Epidural , Headache Disorders , Meningitis , Nerve Block , Pain Management , Post-Dural Puncture Headache , Punctures , Ultrasonography , UnconsciousnessABSTRACT
Rate induced left bundle branch block [LBBB] is a rare peri-operative phenomenon. We encountered rate related LBBB in a 72 year old patient who had undergone a craniotomy. Acute coronary event was ruled out by doing serial troponin-I levels and absence of new onset regional wall motion abnormalities on echocardiogram. The electrocardiographic changes reverted to normal after controlling the rate with beta blockers. Further cardiac evaluation was advised but the patient and family opted for a conservative medical management considering his age and co-morbidities