[A case of cerebrospinal fluid hypovolemia caused by Ommaya reservoir successfully treated by epidural blood patch].
Here, we report a case of cerebrospinal fluid hypovolemia caused by lumbar puncture for implantation of an Ommaya reservoir. A 55-year-old man with central nervous system lymphoma developed meningeal dissemination. He was treated by spinal radiotherapy, and had an Ommaya reservoir implanted for intrathecal injection of anticancer drugs. After one month, he complained of orthostatic neck pain. MRI revealed bilateral subdural effusion and diffuse meningeal enhancement. He was diagnosed as having cerebrospinal fluid hypovolemia. Because no improvement in symptoms was seen after 2 weeks of conservative treatment, he was treated by a lumbar epidural blood patch. Subsequently symptoms improved markedly, and bilateral subdural effusion and diffuse meningeal enhancement disappeared on follow-up MRI.
Jimbo
Yasushi
Y
Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8585, Japan.
Uzuka
Takeo
T
Fujii
Yukihiko
Y
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D017217:Blood Patch, Epidural; D001932:Brain Neoplasms / Q000188:drug therapy; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D019585:Intracranial Hypotension / Q000628:therapy*; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate