cosyntropin and Headache

We conducted a prospective, randomised, double-blind trial to study the effect of Synacthen Depot in 18 parturients with postdural puncture headache following deliberate or accidental dural puncture. Women were randomly allocated to receive either Synacthen Depot 1 mg (1 ml) or 0.9% saline 1 ml intramuscularly. Using a 10-cm visual analogue scale, severity of headache was measured before and at intervals until 48 h after injection. There was no difference in the severity of headache or requirement for epidural blood patch. We conclude that there is no advantage to the use of Synacthen Depot 1 mg for the treatment of postdural puncture headache.

Topics: Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Blood Patch, Epidural; Cosyntropin; Delayed-Action Preparations; Double-Blind Method; Dura Mater; Female; Headache; Humans; Injections, Epidural; Pain Measurement; Pregnancy; Prospective Studies

We present the cases of three women who, within a 6-month period, suffered post-partum generalized tonic-clonic seizures. All had received an epidural in labour for analgesia and were subsequently diagnosed as suffering from postdural puncture headache. All were treated for that headache with Synacthen and one also received sumatriptan before her seizures. All made satisfactory recoveries and were discharged home. None displayed classical patterns suggestive of pre-eclampsia, meningitis, cortical venous thrombosis or any other pathological process that might explain these events adequately, and the specific precipitating factors were left unidentified.

Topics: Adult; Analgesia, Epidural; Anesthesia, Obstetrical; Cosyntropin; Female; Headache; Humans; Seizures; Spinal Puncture; Sumatriptan

Topics: Cosyntropin; Headache; Humans; Injections, Intravenous

Pachymeningitis of unknown origin is uncommon and is usually associated with headaches, cranial nerve lesions and cerebellar ataxia. Magnetic resonance imaging is particularly contributive to diagnosis. The default diagnosis must however be confirmed by brain biopsy. Treatment is not well defined. Basically, corticosteroid therapy, or immunosuppressive therapy in case of failure, is known to have little effect on the brain lesion. We report here a case characterized by headache associated with partial regression of the radiographic lesions.

Topics: Biopsy; Brain; Brain Diseases; Cosyntropin; Diagnosis, Differential; Electroencephalography; Female; Glucocorticoids; Headache; Humans; Magnetic Resonance Imaging; Meningitis; Middle Aged; Prednisolone

Topics: Addison Disease; Adolescent; Anti-Inflammatory Agents; Anuria; Child; Cosyntropin; Cough; Diplopia; Female; Fludrocortisone; Headache; Humans; Hydrocortisone; Male; Mineralocorticoids; Muscle Weakness; Pseudotumor Cerebri; Syncope; Vomiting; Weight Loss

Topics: Adrenocorticotropic Hormone; Aged; Anesthesia, Spinal; Cosyntropin; Headache; Humans; Punctures

Topics: Adrenocorticotropic Hormone; Chronic Disease; Cicatrix; Cosyntropin; Fibromyalgia; Headache; Humans; Neoplasms; Neuralgia; Pain; Palliative Care