Divergence paresis without positional headache: An unusual presentation of cerebrospinal fluid hypovolemia after spinal anesthesia

Anesthesia and Analgesia

Volumn 102, Issue 6, 2006, Pages 1865-1866

  Arai, Motomi ^a   Matsushima, Satoko ^b   Terada, Hiroshi ^b  

^a SEIREI MIKATAHARA GENERAL HOSPITAL   (Japan)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

CINCHOCAINE; GADOLINIUM;

ABDUCENS NERVE PARALYSIS; ADULT; ARTICLE; CASE REPORT; CEREBROSPINAL FLUID; CONTRAST ENHANCEMENT; DIPLOPIA; HEADACHE; HUMAN; HYPOVOLEMIA; MALE; MENINX; NEEDLE; NUCLEAR MAGNETIC RESONANCE IMAGING; PARESIS; PRIORITY JOURNAL; PROSTATECTOMY; PUNCTURE; SPINAL ANESTHESIA; SUBDURAL EFFUSION; SYMPTOMATOLOGY;

EID: 33744483363     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1213/01.ane.0000217117.77826.dd     Document Type: Article

References (16)

1. Mokri B. Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia: evolution of a concept. Mayo Clinic Proc 1999;74:1113-23.
2. Mokri B, Atkinson JLD, Piepgras DG. Absent headache despite CSF volume depletion (intracranial hypotension). Neurology 2000;55:1722-4.
3. Arai M, Takada T, Nozue M. Orthostatic tinnitus: an otological presentation of spontaneous intracranial hypotension. Auris Nasus Larynx 2003;30:85-7.
4. Schabel JE, Wang ED, Glass PSA. Arm pain as an unusual presentation of postdural puncture intracranial hypotension. Anesth Analg 2000;91:910-2.
5. Leigh RJ, Zee DS. Vergence eye movements. In: The neurology of eye movements. 3rd ed. New York: Oxford University Press, 1999:286-318.
6. Wiggins RE, Baumgartner S. Diagnosis and management of divergence weakness in adults. Ophthalmology 1999;106: 1353-6.
7. Mokri B, Parisi JE, Scheithauer BW, et al. Meningeal biopsy in intracranial hypotension: meningeal enhancement on MRI. Neurology 1995;45:1801-7.
8. Mokri B, Piepgras DG, Miller GM. Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 1997;72:400-13.
9. Meltzer CC, Fukui MB, Kanal E, Smirniotopoulos JG. MR imaging of the meninges. Part I. Normal anatomic features and nonneoplastic disease Radiology 1996;201:297-308.
10. Vandam LD, Dripps RD. Long-term follow-up of patients who received 10,098 spinal anesthetics: syndrome of decreased intracranial pressure (headache and ocular and auditory difficulties). JAMA 1956;161:586-91.
11. Gibson BE, Wedel DJ, Faust RJ, Petersen RC. Continuous epidural saline infusion for the treatment of low CSF pressure headache. Anesthesiology 1988;68:789-91.
12. Pannullo SC, Reich JB, Krol G, et al. MRI changes in intracranial hypotension. Neurology 1993;43:919-26.
13. Lee SA, Sunwoo IN, Kim KW. Divergence paralysis due to a small hematoma in the tegmentum of the brainstem. Yonsei Med J 1987;28:326-8.
14. Arai M, Fujii S. Divergence paralysis associated with the ingestion of diazepam. J Neurol 1990;237:45-6.
15. Mays LE. Neural control of vergence eye movements: convergence and divergence neurons in midbrain. J Neurophysiol 1984;51:1091-108.
16. Gamlin PDR, Clarke RJ. Single-unit activity in the primate nucleus reticularis tegmenti pontis related to vergence and ocular accommodation. J Neurophysiol 1995;73:2115-9.