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KMID : 1155520080030040330
Anesthesia and Pain Medicine
2008 Volume.3 No. 4 p.330 ~ p.333
Treatment of spontaneous intracranial hypotension with multiple leakage sites of cerebrospinal fluid -A case report-
Ko Hee-Chang

Song Jang-Ho
Jung Jong-Kwon
Cha Young-Deog
Eum Son-Hyoung
Moon Hyun-Seok
Abstract
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.
KEYWORD
cerebrospinal fluid, epidural blood patch, headache, spontaneous intracranial hypotension
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