Biomaterial Database

Post-dural puncture thoracic pain without headache: relief with epidural blood patch. 1995

S A Dunbar, and N P 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.

UI	MeSH Term	Description	Entries
D007268	Injections, Epidural	The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.	Epidural Injections,Extradural Injections,Peridural Injections,Injections, Extradural,Injections, Peridural,Epidural Injection,Extradural Injection,Injection, Epidural,Injection, Extradural,Injection, Peridural,Peridural Injection
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009325	Nausea	An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.
D011187	Posture	The position or physical attitude of the body.	Postures
D004244	Dizziness	An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness.	Lightheadedness,Orthostasis,Dizzyness,Light-Headedness,Light Headedness
D004388	Dura Mater	The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord.	Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D005260	Female		Females
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006261	Headache	The symptom of PAIN in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of HEADACHE DISORDERS.	Cephalgia,Hemicrania,Bilateral Headache,Cephalalgia,Cephalodynia,Cranial Pain,Generalized Headache,Head Pain,Ocular Headache,Orthostatic Headache,Periorbital Headache,Retro-Ocular Headache,Sharp Headache,Throbbing Headache,Unilateral Headache,Vertex Headache,Bilateral Headaches,Cephalalgias,Cephalgias,Cephalodynias,Cranial Pains,Generalized Headaches,Head Pains,Headache, Bilateral,Headache, Generalized,Headache, Ocular,Headache, Orthostatic,Headache, Periorbital,Headache, Retro-Ocular,Headache, Sharp,Headache, Throbbing,Headache, Unilateral,Headache, Vertex,Headaches,Headaches, Bilateral,Headaches, Generalized,Headaches, Ocular,Headaches, Orthostatic,Headaches, Periorbital,Headaches, Retro-Ocular,Headaches, Sharp,Headaches, Throbbing,Headaches, Unilateral,Headaches, Vertex,Ocular Headaches,Orthostatic Headaches,Pain, Cranial,Pain, Head,Pains, Cranial,Pains, Head,Periorbital Headaches,Retro Ocular Headache,Retro-Ocular Headaches,Sharp Headaches,Throbbing Headaches,Unilateral Headaches,Vertex Headaches