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1.
Rev. colomb. anestesiol ; 49(3): e300, July-Sept. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1280179

ABSTRACT

Abstract Post-dural puncture headache is a frequent complication in neuraxial approaches. It may result in disability, healthcare dissatisfaction and potentially serious complications. The traditional initial management includes general and analgesia measures with poor evidence. The treatment approach best supported by the literature is the epidural blood patch for which rates of up 70% improvement have been reported. Regional techniques have been recently described that may be helpful because they are less invasive than the epidural blood patch, under certain clinical circumstances. This article suggests an algorithm that uses such techniques for the management of this complication.


Resumen La cefalea pospunción dural es una complicación frecuente del abordaje del neuroeje. Puede producir incapacidad, insatisfacción con la atención en salud y complicaciones potencialmente graves. Tradicionalmente su manejo inicial incluye medidas generales y de analgesia las cuales tienen baja evidencia. La medida para su tratamiento, con mejor soporte en la literatura, es la realización de parche hemático, el cual informa tazas de mejoría hasta del 70 %. Recientemente se han descrito técnicas regionales, que pueden resultar útiles por ser menos invasivas que el parche hemático, en ciertos contextos clínicos. En este artículo se propone un algoritmo que permite incorporar dichas técnicas al manejo de esta complicación.


Subject(s)
Humans , Male , Female , Therapeutics , Blood Patch, Epidural , Post-Dural Puncture Headache , Headache , Analgesia , Nerve Block , Delivery of Health Care , Anesthesia, Conduction
3.
Article in Korean | WPRIM | ID: wpr-766769

ABSTRACT

Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, diffuse dural thickening, and enhancement in magnetic resonance imaging. Cerebral venous thrombosis (CVT) has been reported to be a rare complication of SIH. There is no consensus in anticoagulation treatment of CVT secondarily caused by SIH. We report a female patient with SIH complicated by CVT and spontaneously regressed CVT not by anticoagulation but by epidural blood patch.


Subject(s)
Blood Patch, Epidural , Consensus , Female , Headache , Humans , Intracranial Hypotension , Magnetic Resonance Imaging , Venous Thrombosis
4.
Article in English | WPRIM | ID: wpr-759985

ABSTRACT

We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.


Subject(s)
Adult , Arachnoid , Blood Patch, Epidural , Cerebrospinal Fluid Leak , Cerebrospinal Fluid , Diplopia , Disease Progression , Headache , Humans , Intracranial Hypotension , Laminectomy , Magnetic Resonance Imaging , Membranes , Neck Pain , Paraparesis , Spinal Cord , Subarachnoid Space
5.
Article in English | WPRIM | ID: wpr-762267

ABSTRACT

BACKGROUND: Spontaneous intracranial hypotension (SIH) is a condition caused by spontaneous leakage of cerebrospinal fluid, with postural headache as the primary symptom. Orthostatic headache caused by SIH is often not resolved by conservative management. CASE: We performed 15 epidural blood patch treatments in a 43-year-old female patient; however, they were only transiently effective. To improve the patient's SIH and orthostatic headache, epidural fibrin glue patch treatment was attempted. Fibrin glue is a substance that can act as a bio-friendly adhesive by facilitating the coagulation cascade. In our case, 3 epidural fibrin glue patch treatments were performed and the symptoms completely resolved. CONCLUSIONS: The epidural fibrin glue patch may be beneficial for the treatment of refractory postural headaches caused by SIH.


Subject(s)
Adhesives , Adult , Blood Patch, Epidural , Cerebrospinal Fluid , Female , Fibrin Tissue Adhesive , Fibrin , Headache , Humans , Intracranial Hypotension
6.
Article in English | WPRIM | ID: wpr-762248

ABSTRACT

A 55-year-old man with an implantable intrathecal drug delivery system (IDDS) implant removal surgery was performed to control a suspected implant infection. Clear discharge from a lumbar wound was detected after IDDS removal, but transcutaneous cerebral spinal fluid (CSF) leakage was not suspected because the patient did not suffer from a postural headache. Finally, a suspected CSF leakage was resolved with a single epidural blood patch.


Subject(s)
Blood Patch, Epidural , Drug Delivery Systems , Headache , Humans , Middle Aged , Neuralgia, Postherpetic , Wounds and Injuries
7.
Article in English | WPRIM | ID: wpr-739972

ABSTRACT

Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.


Subject(s)
Abducens Nerve Diseases , Adult , Bed Rest , Blood Patch, Epidural , Diplopia , Female , Headache , Hearing , Humans , Intracranial Hypotension , Nausea , Vertigo , Vision Disorders , Vomiting
8.
Article in English | WPRIM | ID: wpr-713398

ABSTRACT

A 34-year-old woman came to the emergency room complaining of a severe orthostatic headache. Results of a cerebrospinal fluid tap and brain computed tomography were normal. Based on her history and symptoms, she was found to have spontaneous intracranial hypotension. She was hospitalized and her symptoms improved with conservative treatment. On the next day, her headache suddenly worsened. Cisternography was performed to confirm the diagnosis and determine the spinal level of her cerebrospinal fluid leak. It revealed multiple cerebrospinal fluid leaks in the lumbar and upper thoracic regions. It was strongly believed that she had an iatrogenic cerebrospinal fluid leak in the lumbar region. An epidural blood patch was performed level by level on the lumbar and upper thoracic regions. Her symptoms resolved after the epidural blood patch and she was later discharged without any complications. In this case, an iatrogenic cerebrospinal fluid leak was caused by a dural puncture made while diagnosing spontaneous intracranial hypotension, which is always a risk and hampers the patient's progress. Therefore, in cases of spontaneous intracranial hypotension, an effort to minimize dural punctures is needed and a non-invasive test such as magnetic resonance imaging should be considered first.


Subject(s)
Adult , Blood Patch, Epidural , Brain , Cerebrospinal Fluid Leak , Cerebrospinal Fluid , Diagnosis , Emergency Service, Hospital , Female , Headache , Humans , Intracranial Hypotension , Lumbosacral Region , Magnetic Resonance Imaging , Post-Dural Puncture Headache , Punctures
9.
Article in English | WPRIM | ID: wpr-742181

ABSTRACT

The Epidural blood patch is considered the gold standard for managing postdural puncture headache when supportive measures fail. However, it is a procedure which can lead to another inadvertent dural puncture. Other potential adverse events that could occur during a blood patch are meningitis, neurological deficits, and unconsciousness. The bilateral greater occipital nerve block has been used for treating chronic headaches in patients with PDPH with a single injection. This minimally invasive, simple procedure can be considered for patients early, along with other supportive treatment, and an epidural blood patch can be avoided.


Subject(s)
Blood Patch, Epidural , Headache Disorders , Humans , Meningitis , Nerve Block , Pain Management , Post-Dural Puncture Headache , Punctures , Ultrasonography , Unconsciousness
10.
Article in English | WPRIM | ID: wpr-330439

ABSTRACT

Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this review, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms.


Subject(s)
Blood Patch, Epidural , Cerebrospinal Fluid Leak , Therapeutics , Dura Mater , General Surgery , Humans , Suture Techniques
11.
Article in English | WPRIM | ID: wpr-34199

ABSTRACT

Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration. An epidural blood patch is the most effective treatment option for patients with unsuccessful conservative management. Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH.


Subject(s)
Bed Rest , Blood Patch, Epidural , Body Mass Index , Caffeine , Deception , Diagnosis , Female , Headache , Humans , Needles , Post-Dural Puncture Headache , Pregnancy , Punctures , Risk Factors
12.
Article in English | WPRIM | ID: wpr-192938

ABSTRACT

The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients. EBP can be still considered if an SPG block is not able to alleviate pain due to PDPH.


Subject(s)
Blood Patch, Epidural , Ganglia, Parasympathetic , Ganglion Cysts , Headache , Humans , Pain Management , Post-Dural Puncture Headache , Pterygopalatine Fossa , Sphenopalatine Ganglion Block
13.
Rev. bras. anestesiol ; 66(5): 445-450, Sept.-Oct. 2016. tab, graf
Article in English | LILACS | ID: lil-794799

ABSTRACT

Abstract Background: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region. GON blockage has been used for the treatment of many kinds of headache. The aim of this retrospective study is to present the results of PDPH treated with GON block over 1 year period in our institute. Methods: 16 patients who had been diagnosed to have PDPH, and performed GON block after caesarean operations were included in the study. GON blocks were performed as the first treatment directly after diagnose of the PDPH with levobupivacaine and dexamethasone. Results: The mean VAS score of the patients was 8.75 (±0.93) before the block; 3.87 (±1.78) 10 min after the block; 1.18 (±2.04) 2 h after the block and 2.13 (±1.64) 24 h after the block. No adverse effects were observed. Conclusions: Treatment of PDPH with GON block seems to be a minimal invasive, easy and effective method especially after caesarean operations. A GON block may be considered before the application of a blood patch.


Resumo Justificativa: A cefaleia pós-punção dural (CPPD) é uma complicação importante da anestesia neuroaxial e mais frequentemente observada em grávidas. A dor é descrita como intensa, perturbadora, e sua localização é geralmente fronto-occipital. O tratamento conservador da CPPD consiste em repouso no leito, fluidoterapia, analgésicos e cafeína. O tampão sanguíneo peridural é o padrão ouro de tratamento, mas é um método invasivo. O nervo occipital maior (NOM) é formado por fibras sensoriais com origem nos segmentos C2 e C3 da medula espinhal e é o principal nervo sensorial da região occipital. O bloqueio do NOM tem sido usado para o tratamento de muitos tipos de dor de cabeça. O objetivo deste estudo retrospectivo foi apresentar os resultados de CPPD tratada com bloqueio do NOM no período de um ano em nosso instituto. Métodos: Foram incluídas no estudo 16 pacientes diagnosticadas com CPPD e submetidas a bloqueio de NOM após cesariana. Os bloqueios do NOM foram feitos com levobupivacaína e dexametasona como o primeiro tratamento imediatamente após o diagnóstico de CPPD. Resultados: A média dos escores EVA das pacientes foi de 8,75 (±0,93) antes do bloqueio; 3,87 (±1,78) 10 minutos após o bloqueio; 1,18 (±2,04) duas horas após o bloqueio e 2,13 (±1,64) 24 horas após o bloqueio. Efeitos adversos não foram observados. Conclusões: O tratamento da CPPD com bloqueio do NOM parece ser um método minimamente invasivo, fácil e eficaz, especialmente após cesarianas. O bloqueio do NOM pode ser considerado antes da aplicação de um tampão sanguíneo peridural.


Subject(s)
Humans , Female , Pregnancy , Adult , Cesarean Section/adverse effects , Cesarean Section/methods , Cranial Nerves , Post-Dural Puncture Headache/drug therapy , Nerve Block/methods , Pain Measurement , Bupivacaine/administration & dosage , Bupivacaine/analogs & derivatives , Bupivacaine/therapeutic use , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Retrospective Studies , Blood Patch, Epidural , Levobupivacaine , Anesthesia, Obstetrical , Anesthesia, Spinal , Anesthetics, Local/administration & dosage , Anesthetics, Local/therapeutic use
14.
Article in English | WPRIM | ID: wpr-229054

ABSTRACT

We report a healthy patient with postpartum headache and neck stiffness which were diagnosed as symptoms of pseudoaneurysm of vertebral artery. She had received a Cesarean section under the spinal anesthesia, and complaint of headache and neck stiffness. Epidural blood patches were done twice, but symptoms persisted. Eight days later, she experienced sensory disturbance and emergent laminectomy was done. When persistent postpartum headache occurs after epidural blood patch, more precise differential diagnosis should be made and considering other possible pathologies.


Subject(s)
Anesthesia, Spinal , Aneurysm, False , Blood Patch, Epidural , Cesarean Section , Diagnosis, Differential , Female , Headache , Hematoma, Subdural, Spinal , Humans , Laminectomy , Neck , Pathology , Post-Dural Puncture Headache , Postpartum Period , Pregnancy , Vertebral Artery
15.
Article in English | WPRIM | ID: wpr-28315

ABSTRACT

Chronic subdural hematoma (SDH) is a well-known disease entity and is traditionally managed with surgery. However, when associated with spontaneous intracranial hypotension (SIH), the treatment strategy ought to be modified, as classical treatment could lead to unwanted consequences. A 59-year-old man presented with a case of SIH that manifested as a bilateral chronic SDH. He developed fatal extensive pneumocephalus and SDH re-accumulation as a complication of burr-hole drainage. Despite application of an epidural blood patch, the spinal cerebrospinal fluid leak continued, which required open spinal surgery. Chronic SDH management should not be overlooked, especially if the exact cause has not been determined. When chronic SDH assumed to be associated with SIH, the neurosurgeon should determine the exact cause of SIH in order to effectively correct the cause.


Subject(s)
Blood Patch, Epidural , Cerebrospinal Fluid , Drainage , Hematoma, Subdural, Chronic , Humans , Intracranial Hypotension , Middle Aged , Pneumocephalus
16.
Rev. obstet. ginecol. Venezuela ; 75(4): 225-231, dic. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-783104

ABSTRACT

OBJETIVO: comparar la efectividad terapéutica del parche hemático transvaginal endocervical autólogo en casos de ruptura prematura de membranas pretérmino frente al llamado tratamiento expectante. MÉTODOS: Ensayo controlado, aleatorio y prospectivo teniendo como variables determinantes el tiempo de latencia de la ruptura y la sobrevida de los recién nacidos. En un período de 12 semanas, solo 35 pacientes con edades comprendidas entre 16 y 37 y promedio de 26,5 años, cumplieron los criterios de inclusión. La edad de gestación tuvo una media de 23,5 ± 3,92 semanas. Con distribución aleatoria, se formaron dos grupos independientes y estadísticamente comparables donde el primero con 9 casos (25,7.%) fue tratado con el parche hemático y el segundo considerado grupo control, con 26 casos (74,2.%) recibió el tratamiento expectante. RESULTADOS: Con un nivel de significancia de 0,05 hubo una diferencia significativa tanto en el período de latencia (P=0,002) como en la sobrevida de los recién nacidos (P=0,006) demostrando la efectividad terapéutica del parche frente al tratamiento expectante. No hubo diferencia referente a la edad materna y la edad gestacional. Con el tratamiento con el parche hemático la reducción del riesgo absoluto fue de 54,70 %, el riesgo relativo de muerte de 0,289, la reducción del riesgo relativo de muerte del 71,11 % , el número necesario de pacientes a tratar fue de 1,83 pacientes y "Odds Ratio"= 0,09 (0,086). El parche hemático no evidenció efectos adversos, complicaciones y fue de bajo costo. CONCLUSIONES: Los resultados obtenidos demuestran de manera significativa la efectividad terapéutica del parche hemático frente al tratamiento expectante, mejorando tanto el período de latencia del embarazo como la sobrevida de los recién nacidos con ruptura de membranas ovulares pretermino.


OBJECTIVE: to compare the therapeutic effectiveness of the autologous endocervical transvaginal blood patch, in cases of preterm premature rupture of membranes, versus the so called expectant treatment. METHODS: Controlled, randomized and prospective trial having latency time of the break and survival of newborns as determining variables. In a 12-week period, only 35 patients aged between 16 and 37 and averaging 26,5 years, met the inclusion criteria. Gestational age had an average of 23.5 ± 3.92 weeks. With a random distribution, two independent and statistically comparable groups where formed; where the first one, with nine cases (25.7 %), was treated with the blood patch; and the second one, with 26 (74.2%), and considered the control group, received expectant treatment. RESULTS: With a significance level of 0.05, there was a significant difference in both the latency period (P = 0.002) and the survival of newborns (P = 0.006), demonstrating the therapeutic effectiveness of the patch as compared with the expectant treatment. There was no difference regarding maternal age and gestational age. With the blood patch treatment, Absolute Risk Reduction (ARR) was 54.70 %; the relative risk of death (RR), of 0.289; the reduction of the relative risk of death (RRR), of 71.11 %; the number needed to treat (NNT) was 1.83 patients; and the "Odds ratio" (OR) = 0.09 (0.086). The blood patch did not report adverse effects, complications and was inexpensive. CONCLUSIONS: The results show a significant therapeutic effectiveness of the blood patch versus the expectant treatment, improving both the latency period of pregnancy and the survival of infants in cases of preterm rupture of ovular membranes.


Subject(s)
Humans , Female , Infant, Newborn , Anthrax , Blood Patch, Epidural , Membranes , Epidural Space
17.
Rev. bras. anestesiol ; 65(4): 306-309, July-Aug. 2015. ilus
Article in English | LILACS | ID: lil-755139

ABSTRACT

We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.

.

Apresentamos o caso clínico de uma paciente de 25 anos na qual uma técnica peridural foi aplicada durante o trabalho de parto e posteriormente apresentou cefaleia com características de cefaleia pós-punção dural. Foi iniciado tratamento conservador e tampão de sangue peridural. Devido à ausência de melhoria clínica e à mudança do componente postural da cefaleia, decidiu-se fazer um exame de imagem cerebral que demonstrou a presença de hematoma subdural bilateral. A cefaleia pós-punção dural é relativamente frequente, mas a falta de resposta ao tratamento médico instaurado, assim como a mudança em suas características e a presença de foco neurológico, deve levantar a suspeita de presença de um hematoma subdural que, embora infrequente, pode chegar a ser devastador se não for diagnosticado e tratado oportunamente.

.

Presentamos el caso clínico de una paciente de 25 años de edad, a quien se le realizó una técnica epidural durante el trabajo de parto y posteriormente presentó cefalea con características de cefalea pospunción dural. Se inició tratamiento conservador y se realizó parche hemático epidural. Ante la falta de mejoría clínica y debido al cambio en el componente postural de la cefalea, se decidió realizar una prueba de imagen cerebral que demostró la presencia de hematoma subdural bilateral. La cefalea pospunción dural es relativamente frecuente, pero la falta de respuesta al tratamiento médico instaurado, así como el cambio en sus características y la presencia de focalidad neurológica, deben hacer sospechar la presencia de un hematoma subdural que, aunque infrecuente, puede llegar a ser devastador si no se diagnostica y trata oportunamente.

.


Subject(s)
Humans , Female , Pregnancy , Adult , Analgesia, Epidural/adverse effects , Analgesia, Obstetrical/adverse effects , Hematoma, Subdural/etiology , Analgesia, Epidural/methods , Analgesia, Obstetrical/methods , Blood Patch, Epidural/methods , Labor Pain/drug therapy , Post-Dural Puncture Headache/etiology , Post-Dural Puncture Headache/therapy , Neuroimaging/methods , Hematoma, Subdural/diagnosis
18.
Article in English | WPRIM | ID: wpr-38865

ABSTRACT

Intracranial hypotension (IH) can occur following lumbar drainage for clipping of an intracranial aneurysm. We observed 3 cases of IH, which were all successfully treated by epidural blood patch (EBP). Herein, the authors report our cases.


Subject(s)
Blood Patch, Epidural , Cerebrospinal Fluid , Drainage , Intracranial Aneurysm , Intracranial Hypotension , Retrospective Studies
19.
Chinese Medical Journal ; (24): 2063-2066, 2014.
Article in English | WPRIM | ID: wpr-248046

ABSTRACT

<p><b>BACKGROUND</b>Subdural hematoma (SDH) is a common complication of spontaneous intracranial hypotension (SIH). To date, the management of SDH caused by SIH remains controversial. In this paper, we reviewed the clinical course of SDH in patients with SIH, and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch (EBP) surgery.</p><p><b>METHODS</b>We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology center. Patients who received early CT/MRI follow-up after EBP operation were included.</p><p><b>RESULTS</b>A series of four cases of SIH complicated with SDHs were evaluated. Early follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch treatment.</p><p><b>CONCLUSION</b>Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.</p>


Subject(s)
Adult , Blood Patch, Epidural , Female , Hematoma, Subdural , Therapeutics , Humans , Intracranial Hypotension , Therapeutics , Male , Middle Aged , Retrospective Studies
20.
Article in Korean | WPRIM | ID: wpr-69008

ABSTRACT

Spontaneous intracranial hypotension is a syndrome caused by cerebrospinal fluid (CSF) leakage from the spinal dural sac. The most common symptom is a postural headache and other clinical symptoms may include nausea, vomiting, photophobia, diplopia, dizziness, and tinnitus. Usually, conservative treatments like hydration, bed rest, and administration of caffeine are recommended first, but epidural blood patch is regarded as the mainstay of treatment in the patients who do not respond to conservative therapy. Epidural blood patch was known that it provides the tamponade and seal of dural sac when performed at the leak site. Our patient was suspected the CSF leakage at cervicothoracic junction, but epidural blood patch was performed in lumbar level and the headache of patient was managed successfully for at least 1 year.


Subject(s)
Bed Rest , Blood Patch, Epidural , Caffeine , Cerebrospinal Fluid , Diplopia , Dizziness , Headache , Humans , Intracranial Hypotension , Nausea , Photophobia , Tinnitus , Vomiting
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