Image-guided epidural blood patch as effective treatment of intracranial hypotension. A case report
Service de Neurologie, CHU Bretonneau, 37044 Tours Cedex.Neurochirurgie (Impact Factor: 0.41). 04/2003; 49(1):51-4.
We report the case of a patient with postural headache. A CT scan revealed bilateral subdural hygroma. Brain MRI showed diffuse pachymeningeal enhancement. A diagnosis of intracranial hypotension was therefore made. Thoracic cerebrospinal fluid leak was proved by radionuclide cisternography and contrast myelography. Conservative medical treatment was ineffective. Two thoracic epidural blood patches with radiographic control were made. We think the blood patch is the most important element for success.
Article: Blood patchLe Praticien en Anesthésie Réanimation 10/2007; 11(5):404–405. DOI:10.1016/S1279-7960(07)74235-3
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ABSTRACT: A case of spontaneous intracranial hypotension (SIH) caused by a cerebrospinal fluid (CSF) leak at C1-2 is described. The patient, a 46-year-old gentleman, presented to the emergency department with a severe, orthostatic neck pain and occipital headache of sudden onset. He was diagnosed with SIH and admitted, but failed to respond to conservative management. Imaging studies suggested that C1-2 was the spinal level responsible for the CSF leak, and he underwent a blood patch therapy delivered via an epidural catheter inserted from C6-7. His neck pain disappeared a day after the procedure, and he remains free of symptom for more than a year. SIH with a CSF leak at the upper cervical spine may be least amenable to conventional epidural blood patch delivered from the lumbar spine. Delivery of autologous blood patch via an epidural catheter inserted from the lower cervical spine can be a safe and effective method for such patients.Clinical Neurology and Neurosurgery 11/2007; 109(8):716-9. DOI:10.1016/j.clineuro.2007.05.006 · 1.13 Impact Factor
- 01/2015; 03(01). DOI:10.4172/2329-6895.1000205
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