title: Spontaneous intracranial hypotension from calcified thoracic disc protrusions causing CSF leak successfully treated with targeted epidural blood patch.
abstract: Spontaneous spinal cerebrospinal fluid (CSF) leaks are increasingly recognized in patients presenting with orthostatic headache and ultimately diagnosed with intracranial hypotension. While the precise cause of these spontaneous leaks is unknown, it is thought to result from underlying weakness in the spinal meninges and may be associated with meningeal diverticula or Tarlov cysts. Rarely, calcified intervertebral discs or bony osteophytes can result in CSF leakage, which has been described in the surgery literature but not well recognized in the radiology literature. The authors present three cases of patients presenting with CSF leaks from calcified thoracic disc protrusions that were successfully treated with epidural blood patches.
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. amallmendinger@gmail.com
authors: Andrew M
authors: AM
authors: Allmendinger
authors: Thomas C
authors: TC
authors: Lee
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural; D002114:Calcinosis / Q000150:complications*; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006261:Headache / Q000150:complications / Q000209:etiology / Q000628:therapy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000175:diagnosis; D019585:Intracranial Hypotension / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed