Computerized tomography-guided epidural blood patch in the treatment of spontaneous low cerebrospinal fluid pressure headache.
A 54-year-old woman suffering from migraine for 35 years was referred to the pain clinic with a changed pattern of headache that had developed over the last 6 weeks. The pain was located in the central forehead region; aggravation in the prone and immediate relief in the supine position led to the hypothesis of a spontaneous low cerebrospinal fluid (CSF) pressure headache. Cisternography revealed a cyst-like formation in the cervico-thoracic region, indicating cerebrospinal fluid leakage. Magnetic resonance imaging (MRI) myelography confirmed ventral leakage but failed to locate the exact site. Computerized tomography (CT)-guided epidural blood patching between T1 and T2 completely relieved the headache.
Karst
M
M
Department of Anesthesiology, Pain Clinic, Medical School of Hannover, D-30623 Hannover, Germany. Karst.Matthias@MH-Hannover.De
Hollenhorst
J
J
Fink
M
M
Conrad
I
I
D017217:Blood Patch, Epidural / Q000379:methods*; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology* / Q000628:therapy*; D014057:Tomography, X-Ray Computed