title: Retrospective study of epidural blood patch use for spontaneous intracranial hypotension.
abstract: OBJECTIVE
  Spontaneous intracranial hypotension (SIH) is characterized by a severe and disabling headache that is usually orthostatic in nature. Cisternography is a useful diagnostic test for evaluating the presence and location of cerebrospinal fluid (CSF) leakage, and a targeted epidural blood patch (EBP) based on the cisternography findings is a very effective treatment modality for SIH. However, the effects of EBPs are not predictable, making repeat EBPs essential in some cases. The aim of the present study was to find the relationship between the EBP response and cisternographic findings, hypothesizing that the number of required EBPs would increase with an increased number of CSF leakage levels as determined by radionuclide cisternography.
  
  
  METHODS
  All patients who underwent an EBP and had been discharged with significant improvements in symptoms of SIH during 2006 to 2011 were enrolled. Patients who had no radionuclide cisternographic results were excluded. The demographic variables, number of EBPs, cisternographic findings (location, bilaterality, and number of leakage sites), and preprocedural and postprocedural pain scores were reviewed.
  
  
  RESULTS
  There was no correlation found between the cisternographic findings and the number of EBPs. Only the preprocedural pain scores showed a statistically significant correlation with the number of EBPs.
  
  
  CONCLUSIONS
  Our study suggests that the response to the EBP is related to the severity of symptoms but not to the number and locations of cisternographic CSF leakages.
authors.affiliation: From the *Asan Medical Center and College of Medicine, University of Ulsan, Pungnap-dong, Seoul, Korea; and †Lynn Women's Hospital, Jangan-dong, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Joo
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Hwang
authors.forename: Yu Gyeong
authors.initials: YG
authors.lastname: Kong
authors.forename: Jong Hyuk
authors.initials: JH
authors.lastname: Lee
authors.forename: Beom Sang
authors.initials: BS
authors.lastname: Hwang
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D017217:Blood Patch, Epidural / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult