J Korean Neurosurg Soc.  2011 Sep;50(3):274-276. 10.3340/jkns.2011.50.3.274.

Chronic Subdural Hematoma after Spontaneous Intracranial Hypotension : A Case Treated with Epidural Blood Patch on C1-2

• Kim BW
• Jung YJ
• Kim MS
• Choi BY

• KMID: 1963625
• DOI: http://doi.org/10.3340/jkns.2011.50.3.274

Abstract

Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments including bed rest, hydration and analgesics. Magnetic resonance imaging showed a subdural hematoma in the bilateral fronto-parietal region, and computed tomography (CT) myelography showed a CSF leak originating at the C1-2 level. The patient underwent successful treatment with a CT-guided epidural blood patch at the CSF-leak site after trephination for bilateral SDH.

Keyword

Blood patch; Epidural; Intracranial hypotension; Subdural hematoma

MeSH Terms

Analgesics
Bed Rest
Blood Patch, Epidural*
Cerebrospinal Fluid
Headache
Hematoma, Subdural
Hematoma, Subdural, Chronic*
Humans
Intracranial Hypotension*
Magnetic Resonance Imaging
Male
Middle Aged
Myelography
Trephining
Analgesics