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Epidural blood patch for spontaneous intracranial hypotension with subdural hematoma: A case report and review of literature
- Title
- Epidural blood patch for spontaneous intracranial hypotension with subdural hematoma: A case report and review of literature
- Authors
- Choi S.H.; Lee Y.Y.; Kim W.-J.
- Ewha Authors
- 김원중
- SCOPUS Author ID
- 김원중
- Issue Date
- 2022
- Journal Title
- World Journal of Clinical Cases
- ISSN
- 2307-8960
- Citation
- World Journal of Clinical Cases vol. 10, no. 1, pp. 388 - 396
- Keywords
- Case report; Cerebrospinal fluid; Chronic subdural hematoma; Epidural blood patch; Myelography; Spontaneous intracranial hypotension
- Publisher
- Baishideng Publishing Group Inc
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- BACKGROUND Cerebrospinal fluid (CSF) leakage at C1/2 in spontaneous intracranial hypotension (SIH) is rare. Subdural hematoma (SDH), a serious complication of SIH, may lead to neurological deficits. This report presents a case of SDH after spontaneous C1/2 CSF leakage, which was treated with a targeted epidural blood patch (EBP). CASE SUMMARY A 60-year-old man with no history of trauma was admitted to our hospital with orthostatic headache, nausea, and vomiting. Brain computed tomography imaging revealed bilateral, subacute to chronic SDH. Brain magnetic resonance imaging (MRI) findings were SDH with dural enhancement in the bilateral cerebral convexity and posterior fossa and mild sagging, suggesting SIH. Although the patient underwent burr hole trephination, the patient’s orthostatic headache was aggravated. MR myelography led to a suspicion of CSF leakage at C1/2. Therefore, we performed a targeted cervical EBP using an epidural catheter under fluoroscopic guidance. At 5 d after EBP, a follow-up MR myelography revealed a decrease in the interval size of the CSF collected. Although his symptoms improved, the patient still complained of headaches; therefore, we repeated the targeted cervical EBP 6 d after the initial EBP. Subsequently, his headache had almost disappeared on the 8th day after the repeated EBP. CONCLUSION Targeted EBP is an effective treatment for SDH in patients with SIH due to CSF leakage at C1/2. © 2022. The Author(s). Published by Baishideng Publishing Group Inc. All Rights Reserved.
- DOI
- 10.12998/wjcc.v10.i1.388
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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