J Korean Pain Soc.  1998 Oct;11(2):338-342.

A Case of Epidural Blood Patch to Treat Headache Due to Spontaneous Intracranial Hypotension

• Park SS
• Jang Y
• Cho EC
• Jee SE
• Song HK
• Jung SW

Abstract

Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar punctute, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MR0 of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12ml of autologous blood and remained asymptomatic.

Keyword

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

MeSH Terms

Adult
Anesthesia, Spinal
Blood Patch, Epidural*
Brain
Female
Head
Headache*
Humans
Injections, Epidural
Intracranial Hypotension*
Leukocytosis
Magnetic Resonance Imaging
Meninges
Myelography
Skull
Spinal Injuries