Uso da hidrocortisona no tratamento e na prevenção da cefaléia pós-punção da dura-máter. Relato de casos

Abstract

BACKGROUND AND OBJECTIVES: Post-dural punctureheadache is the most frequent complication after spinal anes-thesia or accidental dural perforation during attempted epiduralblock. This report aimed at describing the use of hydrocortisoneto treat and prevent post-dural puncture headache (PDPH).CASE REPORTS: Three cases in which hydrocortisone wasused to treat and prevent post-dural puncture headache are re-ported. The first is an obstetric patient submitted to Cesareansection with postoperative headache not responding to conven-tional medication and epidural blood patch (EBP), however withtotal remission after intravenous hydrocortisone. The other twopatients, who suffered accidental dural perforation during at-tempted epidural space location, were preventively treated withintravenous hydrocortisone and have not developed headache.CONCLUSIONS: In our cases, hydrocortisone was effective totreat PDPH after failed conservative measures and EBP. Hy-drocortisone for accidental dural perforation patients may beuseful since it is a noninvasive technique and the incidence ofPDPH in this group of patients is high. Controlled studies areneeded to determine the actual role of hydrocortisone in pre-venting and treating PDPH