Post dural puncture headache and its potential to obscure sinister pathologies: A case report

Background Cerebral venous sinus thrombosis (CVT) is a potentially fatal condition that can occur in postpartum period with the hypercoagulable state developed in pregnancy. Accidental dural puncture is found to be a risk factor for CVT. However, common occurrence of post-dural puncture headache (PDPH) following accidental dural puncture can mask the clinical presentation of other serious conditions such as CVT. Case Presentation We present a case of 29-year-old postpartum female who had accidental dural puncture during labour epidural insertion and managed for PDPH subsequently found to have CVT following further investigation due to persistent symptoms. Conclusions This case report would allow increasing awareness among perioperative clinicians to keenly exclude serious pathology in the presence of possible PDPH as this is a diagnosis of exclusion although there is a history of dural puncture.