[Value of epidural blood-patches for the treatment of spontaneous intracranial hypotension].
OBJECTIVE
Spontaneous intracranial hypotension (SIH) is a rare syndrome. It is due most often to a spinal meningeal leak. Symptoms due to SIH are often difficult to treat and epidural blood-patch (BP) has been proposed. The aim was to evaluate the effects and the problems associated with lumbar blood-patch to treat SIH.


METHODS
Case series.


METHODS
The diagnosis of SIH was made in six consecutive patients on clinical signs and radiological findings (CT-scan and MRI). A lumbar BP (L1-L2 level) was performed as soon as possible after diagnosis. A maximum of three procedures was allowed in case of failure of the initial BP.


RESULTS
BP was effective and well tolerated for five patients (3 immediately after BP, 2 others patients needed 2 and 3 BP). In one patient, an incomplete response was observed and was related to a large CFS leak diagnosed by CT-myelogram.


CONCLUSIONS
When the diagnosis of spontaneous intracranial hypotension is confirmed, a repeated blood patch lumbar procedure can be efficient to treat these patients.
Rozec
B
B
Département d'anesthésie'réanimation chirurgicale, CHRU G et R Laënnec, boulevard Jacques-Monod, 44093 Nantes 01, France. bertrand.rozec@chu-nantes.fr
Guillon
B
B
Desal
H
H
Blanloeil
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D017217:Blood Patch, Epidural / Q000009:adverse effects; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome