KMID : 1155520080030040330
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Anesthesia and Pain Medicine 2008 Volume.3 No. 4 p.330 ~ p.333
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Treatment of spontaneous intracranial hypotension with multiple leakage sites of cerebrospinal fluid -A case report-
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Ko Hee-Chang
Song Jang-Ho Jung Jong-Kwon Cha Young-Deog Eum Son-Hyoung Moon Hyun-Seok
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Abstract
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Spontaneous intracranial hypotension (SIH) is an uncommon disease that¡¯s caused by cerebrospinal fluid (CSF) leakage and this disease is considered to be an important cause of persistent headache. It is characterized by a postural headache in patients who are without any history of dural puncture or trauma. Conservative management, including bed rest analgesics and intravenous fluid administration, are the first-line treatment of SIH, and an autologous epidural blood patch (EBP) is generally indicated for those who fail the conservative management. We report here on a case of SIH with confirmed CSF leakage at the cervical, thoracic and lumbar levels, and this was successfully managed with a single autologous EBP at the lumbar level. We believe that an EBP at the leakage site with the highest pressure level should be considered as a primary treatment for SIH with multiple sites of leakage.
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KEYWORD
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cerebrospinal fluid, epidural blood patch, headache, spontaneous intracranial hypotension
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