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KMID : 0948920120110020098
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Clinical Pain
2012 Volume.11 No. 2 p.98 ~ p.101
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Posterior Neck Pain Due to Cervical Cerebrospinal Fluid Leakage -Spontaneous Intracranial Hypotension-
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Park Yoon-Hong
Sung Duk-Hyun
Park Myung-Seok
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Abstract
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Spontaneous intracranial hypotension (SIH) is a rare syndrome characterized by postural headache associated with a low cerebrospinal fluid (CSF) pressure in the absence of dural puncture or penetrating trauma. A 35 years-old woman with headache and nuchal pain visited our outpatient clinic. Pain was aggravated by sitting, standing and neck extension and relieved by lying down. Cervical spine MRI showed fluid signal in epidural space from the fifth cervical level to upper thoracic level was found. Also an extensive retrospinal fluid collection was found between the C1-C2, which suggested CSF leakage. CSF leakage site was found in whole spine CT-myelography. It revealed that posterior osteophyte of the T1-T2 vertebral body might cause dura tear and epidural CSF leakage from the first cervical level to third thoracic level. Epidural blood patch (EBP) was done via C7-T1 interlaminar approach. After EBP, headache and nuchal pain was disappeared.
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KEYWORD
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Posterior neck pain, Cerebrospinal fluid (CSF) hypotension, Retrospinal fluid collection
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