Extensive epidural fluid collections: does it influence the outcome?

Abstract

A 32-year-old woman presented with a three-day history of orthostatic headache. Brain CT and MRI were normal. Hole-spine MR mielography and conventional Spine MRI disclosed exuberant enlargement of posterior epidural space and images suggestive of cervical CSF leak (Fig 1). CT myelography confirmed CSF leak. It was performed conservative treatment without symptom relief. Clinical improvement was only evident after third epidural blood patch. Five months later, she remained asymptomatic despite mantaining exuberant collections, not supporting a correlation between imagiological and clinical improvement (Fig 2). Another question that remains to be solved is whether the extent of the collections of CSF influences the outcome 1 .