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Aminophylline Injection Alleviates Pain in Postdural Puncture Headache.

Dear Editor,

Lumbar puncture is used to obtain a sample of cerebrospinal fluid (CSF) to aid in the diagnosis of neural system disorders. Postdural puncture headache (PDPH) is a disabling complication of lumbar puncture. The classic symptoms of PDPH consist of postural headache, nausea and vomiting, neck stiffness, tinnitus, and diplopia. Although enormous progress has been made in understanding this clinical entity, including its epidemiology, pathophysiology, clinical symptoms, prevention, and treatment, it still needs further study ⇓. Herein, we describe the case of a patient with severe PDPH who markedly improved with aminophylline injection.

A 57-year-old woman without significant medical history was admitted for persistent dizziness. The dizziness had started 1 week earlier and she had fever before the dizziness. Her physical examination, neurological examination, blood biochemistry test, electrocardiogram, and brain magnetic resonance imaging (MRI) were normal. The patient underwent an uncomplicated lumbar puncture with an 18-gauge pencil-point spinal needle followed by the removal of 8 mL of CSF to exclude intracranial infection. The CSF pressure was 160 cmH2O before the lumbar puncture and 145 cmH2O after the lumbar puncture and the CSF studies were also normal. She was advised to maintain supine position after lumbar puncture for 6 hours.

Six …