{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T22:17:37Z","timestamp":1775686657808,"version":"3.50.1"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>Headache occurs after dural puncture in about 1%\u201325% of children who undergo the procedure\u2014a rate similar to that seen in adults. Persistence of post\u2013dural puncture headache in spite of bed rest, increased fluid intake, and epidural blood patch treatment, however, is rare. The authors reviewed the medical records and imaging studies of all patients 19 years of age or younger who they evaluated between 2001 and 2010 for intracranial hypotension, and they identified 8 children who had persistent post\u2013dural puncture headache despite maximal medical treatment and placement of epidural blood patches. A CSF leak could be demonstrated radiologically and treated surgically in 3 of these patients, and the authors report these 3 cases.<\/jats:p>\n<jats:p>The patients were 2 girls (ages 14 and 16 years) who had undergone lumbar puncture for evaluation of headache and fever and 1 boy (age 13 years) who had undergone placement of a lumboperitoneal shunt using a Tuohy needle for treatment of pseudotumor cerebri. The boy also had undergone a laminectomy and exploration of the posterior dural sac, but no CSF leak could be identified. All 3 patients presented with new-onset orthostatic headaches, and in all 3 cases MRI demonstrated a large ventral lumbar or thoracolumbar CSF collection. Conventional myelography or digital subtraction myelography revealed a ventral dural defect at L2\u20133 requiring surgical repair. Through a posterior transdural approach, the dural defect was repaired using 6-0 Prolene sutures and a dural substitute. Postoperative recovery was uneventful, with complete resolution of orthostatic headache and of the ventral cerebrospinal fluid leak on MRI.<\/jats:p>\n<jats:p>The authors conclude that persistent postdural puncture headache requiring surgical repair is rare in children. They note that the CSF leak may be located ventrally and may require conventional or digital subtraction myelography for exact localization and that transdural repair is safe and effective in eliminating the headaches.<\/jats:p>","DOI":"10.3171\/2012.10.peds12353","type":"journal-article","created":{"date-parts":[[2012,11,9]],"date-time":"2012-11-09T15:03:14Z","timestamp":1352473394000},"page":"48-51","source":"Crossref","is-referenced-by-count":13,"title":["Ventral spinal cerebrospinal fluid leak as the cause of persistent post\u2013dural puncture headache in children"],"prefix":"10.3171","volume":"11","author":[{"given":"Wouter I.","family":"Schievink","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Marcel","family":"Maya","sequence":"additional","affiliation":[{"name":"Radiology, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds12353","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1111\/j.1460-9592.2009.03236.x","article-title":"Spinal needle design and size affect the incidence of postdural puncture headache in children","volume":"20","author":"Apiliogullari","year":"2010"},{"key":"b2-peds12353","series-title":"Headache","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1111\/j.1526-4610.2010.01758.x","article-title":"Post-dural puncture headache: part II\u2014prevention, management, and prognosis","volume":"50","author":"Bezov","year":"2010"},{"key":"b3-peds12353","series-title":"Headache","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1111\/j.1526-4610.2010.01699.x","article-title":"Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology","volume":"50","author":"Bezov","year":"2010"},{"key":"b4-peds12353","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1542\/peds.113.6.1588","article-title":"Headache and backache after lumbar puncture in children and adolescents: a prospective study","volume":"113","author":"Ebinger","year":"2004"},{"key":"b5-peds12353","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3174\/ajnr.A1294","article-title":"Localization of a rapid CSF leak with digital subtraction myelography","volume":"30","author":"Hoxworth","year":"2009"},{"key":"b6-peds12353","series-title":"Acta Anaesthesiol Scand","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1111\/j.1399-6576.2005.00837.x","article-title":"High success rate and low incidence of headache and neurological symptoms with two spinal needle designs in children","volume":"49","author":"Kokki","year":"2005"},{"key":"b7-peds12353","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.1212\/WNL.42.10.1884","article-title":"Post-lumbar puncture headaches: experience in 501 consecutive procedures","volume":"42","author":"Kuntz","year":"1992"},{"key":"b8-peds12353","series-title":"Arch Pediatr","first-page":"1199","article-title":"[Post lumbar puncture headache in general pediatrics: a prospective multicenter study.]","volume":"12","author":"Leblanc","year":"2005"},{"key":"b9-peds12353","series-title":"AJNR Am J Neuroradiol","first-page":"337","article-title":"Depiction of a postoperative pseudomeningocele with digital subtraction myelography","volume":"23","author":"Phillips","year":"2002"},{"key":"b10-peds12353","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3171\/2011.5.SPINE10890","article-title":"Chronic cerebellar hemorrhage in spontaneous intracranial hypotension: association with ventral spinal cerebrospinal fluid leaks. Clinical article","volume":"15","author":"Schievink","year":"2011"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/11\/1\/article-p48.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/11\/1\/article-p48.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/11\/1\/article-p48.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T14:24:15Z","timestamp":1681568655000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/11\/1\/article-p48.xml"}},"subtitle":["Report of 3 cases"],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":10,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2012.10.peds12353","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}