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Case Report

Rebound Intracranial hypertension: A Complication of Epidural Blood Patch as Treatment for Intracranial Hypotension

Shashank Rane, Department of Anesthesia, Fortis Hospital, Mumbai 4000478, India. , Shashank Rane 1 , Vaishali Shende 2 , Vijay Shetty 3 , Rajesh Benny 4

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Indian Journal of Anesthesia and Analgesia 8(3):p 413-415, May-June 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.59

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Shashank Rane, Vaishali Shende, Vijay Shetty, Rajesh Benny/Rebound Intracranial hypertension: A Complication of Epidural Blood Patch as Treatment for Intracranial Hypotension/Indian J Anesth Analg. 2021;8(3):413-415
 

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Abstract

Rebound intracranial hypertension is a known complication of epidural blood patch. An elderly male presented with nausea, vomiting and poor GCS. The MRI brain showed subdural haematoma with sagging of brain matter suggestive of intracranial hypotension secondary to CSF leak resulting from multiple recent sessions of intrathecal chemotherapy. The patient underwent a lumbar epidural blood patch followed by burr hole procedure under general anaesthesia. The patient had a brief period of complete improvement and subsequently reintubated as his GCS deteriorated. The MRI brain shows mild dilatation of ventricles. The diagnostic lumbar puncture showed a high opening pressure confirming the diagnosis of Intracranial Hypertension. The patient completely resolved symptomatically with oral acetazolamide. Conclusion: Anaesthesiologists must be aware about this condition and efforts at adequate monitoring to detect Intra Cranial Hypertension after an Epidural Blood Patch. Keywords: Epidural blood patch; Rebound intracranial hypertension; Intracranial hypotension.

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Shashank Rane, Vaishali Shende, Vijay Shetty, Rajesh Benny/Rebound Intracranial hypertension: A Complication of Epidural Blood Patch as Treatment for Intracranial Hypotension/Indian J Anesth Analg. 2021;8(3):413-415
 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.59

Keywords

Epidural blood patch; Rebound intracranial hypertension; Intracranial hypotension.

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