Epidural blood patch for spontaneous intracranial hypotension with subdural hematoma: A case report and review of literature

Choi, Se Hee; Lee, Youn Young; Kim, Won-Joong

doi:10.12998/wjcc.v10.i1.388

Cited by 3 publications

(1 citation statement)

References 33 publications

(40 reference statements)

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“…Traditionally, treatment for SIH begins with conservative therapy, including hydration, analgesics, and abdominal binders. Autologous EBP is considered the preferable treatment for patients who have failed initial conservative treatments [16]. Although nontargeted epidural blood patching is often used as a first choice to treat SIH, it may not provide durable relief in a significant number of patients.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report

Cirillo,

Verna,

Princiotta

et al. 2024

Life

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We report a patient suffering from spontaneous intracranial hypotension (SIH) who, following a non-selective lumbar blood patch, returned to his healthcare provider with severe symptoms of neurological deficits. It was subsequently discovered that the aforementioned deficits were due to a bilateral subdural hematoma, and an emergency surgical drainage of the hematoma has been performed. However, the hematoma reformed and potential cerebrospinal fluid leakage was consequently investigated through myelography. Following the diagnostic finding of a venous diverticulum, a selective blood patch was executed in the affected area, and in order to stabilize the hematoma, an embolization of the middle meningeal arteries was performed. The combination of such operations allowed for the resorption of the hematoma and the improvement of neurological symptoms.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report

Cirillo,

Verna,

Princiotta

et al. 2024

Life

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Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension

Su,

Lan,

Cao

et al. 2024

THC

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BACKGROUND: Epidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention. OBJECTIVE: In this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated. METHODS : Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024. RESULTS: The mean age of the fifty-nine patients at symptom onset was 40.8 ± 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 sacns with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months. CONCLUSION: CT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.

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Thunderclap headache revealing dural tears with symptomatic intracranial hypotension: Report of two cases

et al. 2023

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Cerebrospinal fluid (CSF) leakage is considered the cause of spontaneous intracranial hypotension (SIH), an important etiology for new daily persistent headaches and a potentially life-threatening condition. Minor traumatic events rarely lead to CSF leakage, contrasting with iatrogenic interventions such as a lumbar puncture or spinal surgery, which are commonly complicated by dural tears. Most meningeal lesions are found in the cervicothoracic region, followed by the thoracic region, and rarely in the lumbar region, and extremely rarely in the sacral region. We describe two patients admitted to our hospital for severe headaches aggravated in the orthostatic position, with a recent history of minor trauma and sustained physical effort, respectively. In the first case, a bone fragment pierced an incidental congenital meningocele creating a dural fistula. An extensive extradural CSF collection, spanning the cervicothoracic region (C4–T10), was described in the second case. In both patients, the clinical evolution was favorable under conservative treatment.

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Epidural blood patch for spontaneous intracranial hypotension with subdural hematoma: A case report and review of literature

Cited by 3 publications

References 33 publications

Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report

Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report

Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension

Thunderclap headache revealing dural tears with symptomatic intracranial hypotension: Report of two cases

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