Evidence map›Paper›PMID 39872576›Full record

ArticleCureus2024

Overcoming Anatomical Challenges: Epidural Blood Patch and Plica Mediana Dorsalis Case Report.

Isaiah Florence, Steven Yap, Ram Manchandani, Artem Babayan

Abstract readCase Reports
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Isaiah FlorenceAnesthesiology, South Brooklyn Health, Brooklyn, USA.
Steven YapAnesthesiology, South Brooklyn Health, New York, USA.
Ram ManchandaniAnesthesiology, South Brooklyn Health, Brooklyn, USA.
Artem BabayanAnesthesiology, South Brooklyn Health, Brooklyn, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The efficacy of epidural blood patch (EBP) is highly variable, and often, clinicians are unable to identify the underlying reasons for treatment failure. A 36-year-old parturient underwent a "blind" epidural blood patch (EBP) without image guidance but failed to obtain relief from a postural headache related to the labor epidural. During the second EBP, an intact plica mediana dorsalis (PMD) was visualized in the anterior-posterior fluoroscopic view after injection of contrast, and autologous blood was injected on both sides of the PMD, leading to the complete resolution of headache symptoms. This case study presents a unique finding, potentially the first identification of an intact PMD as the etiology behind the failure of an EBP to provide symptomatic relief. The first EBP was performed without image guidance, which would have allowed the identification of an intact PMD. Fluoroscopic guidance, utilizing anterior-posterior and lateral views in combination with an adequate volume of contrast to confirm bilateral spread, enables the identification of anatomic variants such as an intact PMD.

Indexed as

case reportepidural blood patchplica mediana dorsalispost-dural puncture headachespinal csf leak

Identifiers

PMID39872576
PMCPMC11771095

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.