J Korean Pain Soc.  1999 May;12(1):152-156.

Two Cases of Spontaneous Intracranial Hypotension Treated With Epidural Blood Patch

• Cho SK
• Joo HC
• Park CH
• Kim BI
• Lee SH
• Oh HJ

Abstract

Spontaneous intracranial hypotension (SIH) is a rare syndrome which causes postural headache associated with low cerebrospinal fluid (CSF) pressure, without preceding events such as lumbar puncture, back trauma, operative procedure or illness. The headche is usually accompanied by nausea, vomiting, tinnitus, neck stiffness, vertigo, photophobia and in rare cases diplopia, transient visual obscuration. Brain MRI may show subdural effusion, downward displacement of brain and diffuse and continuous meningeal enhancement when enhanced by gadolinium. Low opening pressure was shown through lumbar puncture. The value of protein and cell count of CSF may be slightly elevated. This syndrome usually resolves itself spontaneously or with strict bed rest. When the headache is persistent or incapacitating, more aggressive treatment may be necessary. We treated two cases of SIH in which epidural blood patch produced immediate and complete relief of the symptoms.

Keyword

Pain, spontaneous intracranial hypotension, headache; Technique, epidural blood patch

MeSH Terms

Bed Rest
Blood Patch, Epidural*
Brain
Cell Count
Cerebrospinal Fluid
Diplopia
Gadolinium
Headache
Intracranial Hypotension*
Magnetic Resonance Imaging
Nausea
Neck
Photophobia
Spinal Puncture
Subdural Effusion
Surgical Procedures, Operative
Tinnitus
Vertigo
Vomiting
Gadolinium