title: [Epidural blood patch as a successful treatment of Barrè-Lièou syndrome: report of two cases].
abstract: Barrè-Lièou syndrome accompanies neurological symptoms after neck sprain, and is often difficult to treat. We describe two young men with various neurological symptoms after traffic accident, who were diagnosed with Barrè-Lièou syndrome. Both case 1 (41-year-old man) and case 2 (34-year-old man) showed no abnormal findings in head and cervical X-ray, CT-scan and MRI. Only radionuclide cisternography (RNC) showed cerebrospinal fluid (CSF) leak into epidural space at thoracolumbar level. Three months (case 1) and four years (case 2) had passed after each accident. Two patients underwent epidural blood patch (EBP) for total of three times. The average volumes of the blood used for EBP were 30 ml (case 1) and 24 ml (case 2). The procedure improved various symptoms except for neck stiffness and dizziness. EBP had led to low back pain, which disappeared within three days. CSF leak vanished in RNC after EBP. Severe complication, for example epidural infection or neurological disorders due to hematoma, was not noticed. While neural blockade did not relieve pain before EBP, we could get good effect from neural blockade for remaining symptoms after EBP. We consider that Barrè-Lièou syndrome is due to CSF leak and EBP may be one of the useful treatments.
authors.affiliation: Department of Anesthesiology, Fukuyama Kohnan Hospital, Fukuyama 720-0814.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Katayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahara
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kojo
authors.forename: Eiji
authors.initials: E
authors.lastname: Moriyama
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013128:Spinal Osteophytosis / Q000209:etiology* / Q000628:therapy*; D013353:Subdural Effusion / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome