3169 Complex movement disorder following hypoxic brain injury secondary to cocaine overdose

initiated, followed by sphenopalatine ganglion nerve block, with no significant improvement.An epidural blood patch at 36-weeks' gestation provided only transient benefit.Normal vaginal delivery occurred at 39+4 weeks with persisting headache symptoms and a second blood patch 1-week post-partum provided permanent headache resolution.SIH due to cerebrospinal fluid (CSF) leak is characterised by low CSF pressure, postural headache, and characteristic radiological findings.Aetiology and incidence in pregnancy is unknown.Occurrence in early-mid pregnancy is favoured in case reports. 1 2 Pain is challenging to manage due to limitations on analgesic use in pregnancy.The potential risks of a vaginal delivery and/or administration of epidural analgesia are unknown, and the likelihood of recurrence during future pregnancies remains uncertain.This case highlights the poorly understood aetiology of SIH during pregnancy, and the unique management challenges it presents.