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

Abstract:

:We report a rare complication of spinal anesthesia-divergence paresis-which is characterized by an acquired horizontal diplopia at distance without evidence for abducens palsy. A 64-yr-old man underwent prostatectomy under spinal anesthesia with 2.5 mL of dibucaine hydrochloride 0.3% injected through a 20-gauge cutting-tip spinal needle. Seventeen days after the operation, the patient noticed horizontal diplopia for distant objects. Although cranial magnetic resonance imaging demonstrated diffuse pachymeningeal gadolinium enhancement and subdural effusion, characteristic findings of cerebrospinal fluid hypovolemia, the patient had no positional headache. Gadolinium-enhanced magnetic resonance imaging may be useful when a patient develops neurologic symptoms after dural puncture.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Arai M,Matsushima S,Terada H

doi

10.1213/01.ane.0000217117.77826.dd

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

1865-6

issue

6

eissn

0003-2999

issn

1526-7598

pii

102/6/1865

journal_volume

102

pub_type

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