[A case of spontaneous intracranial hypotension effectively treated with cervical epidural blood patch].
We report a case of cervical spontaneous intracranial hypotension (SIH). The patient is a 46-year-old woman with hard of hearing, dizziness and postural headache. Radionuclide cisternography (RNC) demonstrated a cerebrospinal fluid (CSF) leak at the low cervical region. Resolution of headache was obtained by conservative therapies of bed rest and intravenous (i.v.) drip infusion, but the dizziness remained. We performed epidural blood patch (EBP) with 8 ml of autologous blood at the C 6-7 interspace. Her dizziness disappeared after several days of EBP. SIH is an uncommon disease caused by CSF leakage. SIH is often self-limiting, responding to bed rest and/or i.v. drip infusion. However, if the symptoms of SIH do not show a complete recovery by conservative therapies, EBP or continuous epidural infusion of saline has reportedly been used for the management of these cases. Most of the reported cases of EBP are in the thoracic and lumbar spinal regions. We have performed cervical EBP without complications, and the 6 month-follow-up MRI and RNC demonstrated that the abnormal findings had disappeared.
Asano
Naoko
N
Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550.
Taki
Kazumi
K
Kondo
Toshiki
T
Nishiwaki
Kimitoshi
K
Kimura
Tomomasa
T
Shimada
Yasuhiro
Y
D017217:Blood Patch, Epidural / Q000379:methods*; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged