J Korean Ster Func Neurosurg.  2021 Jun;17(1):24-29. 10.52662/jksfn.2021.00045.

The effectiveness of a blind blood patch at the L1-2 level for the treatment of spontaneous intracranial hypotension

• Kim DK
• Ha SW

• KMID: 2534567
• DOI: http://doi.org/10.52662/jksfn.2021.00045

Abstract

Objective
Spontaneous intracranial hypotension (SIH) is characterized by postural headache due to cerebrospinal fluid (CSF) leakage with an unknown cause. The treatment of SIH includes conservative treatment, such as bed rest and fluid infusion, or surgical repair of the dural defect; however, in recent years, epidural blood patch (EBP) has emerged as a treatment of choice when conservative treatment is ineffective.
Methods
Between January 2015 to April 2021, we performed blind EBP in 17 patients who did not show any improvement in response to conservative treatment. The sites of CSF leakage were different in each patient, but all EBPs were performed at the L1-2 level.
Results
Of the 17 patients who received blind EBP, 10 (58.8%) showed immediate symptomatic relief and no recurrence. Seven patients (41.2%) failed to improve clinically after the first blind EBP, and all of those seven patients underwent repeated blind EBP at the same level. After the second EBP, all patients showed no residual symptoms and no recurrence.
Conclusions
Blind EBP is a safe and easy option for the treatment of SIH, and the L1-2 level deserves consideration as an effective location for performing blind EBP.

Keyword

Spontaneous intracranial hypotension; Epidural blood patch