[Evaluation of epidural blood patch in the treatment of two cases of spontaneous intracranial hypotension].
We evaluated the effect of epidural blood patch (EBP) in the treatment of two cases of spontaneous intracranial hypotension (SIH). Both case 1 (53-year old female) and case 2 (44-year old female) had severe postural headache and showed meningeal thickening by cranial MRI, and were diagnosed as SIH. Case 1: Although her intracranial pressure remained within normal ranges, an extradural leakage was shown in the middle thoracic region on isotope cisternography using indium-111 labeled DTPA. She underwent epidural blood patch with autologous blood at Th 6-7 level twice (10 ml and 15 ml, respectively) but without remarkable pain relief. Case 2: Her intracranial pressure was low (0 mmH2O on supine position), but, isotope cisternography using DTPA showed only the early appearance of isotope in the bladder but failed to disclose the site of the CSF leak. Epidural blood patch with 30 ml of autologous blood was performed at Th 12-L 1 level which only resulted in severe backache without clinical improvement. In conclusion, we could not find the effectiveness of EBP on the two cases of SIH, although there are many reports on its efficacy.
Asakura
M
M
Department of Anesthesia, Asahi General Hospital, Chiba.
Tanno
M
M
Nagai
R
R
Koike
T
T
Murata
K
K
Shimizu
Y
Y
D000328:Adult; D017217:Blood Patch, Epidural; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000628:therapy*; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D016896:Treatment Outcome