RESUMO
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.
Assuntos
Adulto , Feminino , Humanos , Adesivos , Placa de Sangue Epidural , Líquido Cefalorraquidiano , Adesivo Tecidual de Fibrina , Fibrina , Cefaleia , Hipotensão IntracranianaRESUMO
Lumbar epidural block is one of effective methods for treating low back pain with or without radiculopathy. However, neurologic complications can occur after epidural block due to several causes such as direct nerve injury or epidural hematoma. It is important to determine whether the neurologic complication is related to the procedure or is due to the underlying neurologic disease. We report two cases of patients who complained of weakness in their lower extremities after receiving a lumbar epidural block; they were ultimately diagnosed with amyotrophic lateral sclerosis.
