Treatment of idiopathic intracranial hypotension: cervicothoracic and lumbar blood patch and peroral steroid treatment.
METHODS
Twelve consecutive patients with clinical symptoms and testing results compatible with a diagnosis of idiopathic intracranial hypotension (IIH), but no identifiable site of cerebrospinal fluid (CSF) leakage, were treated with a cervicothoracic or lumbar epidural "blood patch" (EBP) or orally administered steroids.


RESULTS
Prompt and complete relief from headache persisting for at least 4 months was attained in 3 of 4 treatments with cervicothoracic EBP, 2 of 15 with lumbar EBP, and 4 of 8 with steroids.


CONCLUSIONS
These results suggest that in patients who presumably suffer from IIH and yet have no identifiable site of CSF leakage, the presumed leakage more often occurs at the cervicothoracic level than the lumbar. In addition, our experience suggests that some IIH patients may be treated effectively with oral steroids and a trial of such therapy may be considered as an alternative to EBP.
Hannerz
Jan
J
Department of Neurology, Karolinska Hospital, Stockholm, Sweden.
Dahlgren
Gunnar
G
Irestedt
Lars
L
Meyerson
Björn
B
Ericson
Kaj
K
D000328:Adult; D000368:Aged; D017217:Blood Patch, Epidural / Q000379:methods*; D005260:Female; D006261:Headache / Q000628:therapy; D006801:Humans; D019585:Intracranial Hypotension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*
D011239:Prednisolone