• A & A case reports · Oct 2017

    Occam's Razor Could Not Cut It: Tale of 2 Headaches in a Postpartum Patient: A Case Report.

    • James A Dolak, Constantinos G Hadjipanayis, and Linda J Demma.
    • From the Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia.
    • A A Case Rep. 2017 Oct 15; 9 (8): 233-235.

    AbstractNot all postpartum headaches are caused by dural puncture, and it is possible for postpartum patients to have >1 cause for headache. After neuraxial block with an incidental large-gauge dural puncture, our patient developed a severe, classic postdural puncture headache which initially responded to an epidural blood patch. The patient was readmitted 2 days after discharge complaining of recurrent headache less characteristic of a postdural puncture headache, now being bifrontal/retro-orbital and without clear positional component. Computerized tomography and magnetic resonance imaging revealed an enlarged pituitary gland with a possible hemorrhagic focus; all endocrine parameters were normal. The patient was ultimately diagnosed with lymphocytic adenohypophysitis, an autoimmune inflammation of the anterior pituitary gland.

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