Cerebrospinal fluid leak treated by aspiration and epidural blood patch under computed tomography guidance.
OBJECTIVE
Cerebrospinal fluid (CSF) leakage secondary to surgery of the spine is usually treated by drainage of CSF through a subarachnoid catheter or surgical repair of the dural tear. We present 2 cases in which the pseudomeningocele was treated by aspiration of the leaked CSF and blood patch under computed tomography (CT) guidance.


METHODS
Two patients had headache after spine surgery. Physical examination showed a bulging accumulation of fluid at the laminectomy site. Aspiration of the fluid followed by injection of the patients' blood was performed aseptically under CT guidance. The patients had resolution of their headache, and follow-up showed no recurrence of the CSF leak.


CONCLUSIONS
CSF leak secondary to a surgical tear of the dura can be successfully treated by aspiration of the fluid followed by injection of the patient's blood. CT guidance is recommended to assess the extent of the CSF leakage, determine the degree of evacuation of the leaked CSF, and to confirm the injection of the blood into the epidural space and the space created by the pseudomeningocele.
Elbiaadi-Aziz
N
N
Department of Anesthesiology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Benzon
H T
HT
Russell
E J
EJ
Mirkovic
S
S
D000328:Adult; D017217:Blood Patch, Epidural; D006261:Headache / Q000209:etiology / Q000628:therapy; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008588:Meningocele / Q000628:therapy; D011183:Postoperative Complications / Q000628:therapy*; D013353:Subdural Effusion / Q000628:therapy*; D014057:Tomography, X-Ray Computed