Abstract
We report a case of spontaneous intracranial hypotension (SIH) treated with a cervical epidural blood patch (EBP). The patient was a 42-year-old woman with severe headache. Myelography CT detected cerebrospinal fluid (CSF) leak at the high cervical region (C2-C3). She was point out subdural hematoma and subdural edema with MRI. Initial treatment was centered on conservative therapy of bed rest and intravenous drip infusion. But the headache showed no sign of receding and in crease of subdural hematoma was concerned. Thus, we decided to simultaneously perform cervical EBP and operation of the subdural hematoma. We performed EBP with 7ml of autologous blood at the C7-Th1 interspace. The patient's headache disappeared immediately after EBP. SIH is an uncommon disease caused by CSF leakage. It is often self-limiting, responding to bed rest and/or intravenous drip infusion. However, if the symptoms of SIH are not dramatically reduced by conservative therapies, EBP has been reportedly used for the management of these cases. The reason EBP is considered to be effective is because it causes a increase in the pressure and volume of cerebrospinal fluid and autologous blood patches up the fluid leakage. We believe EBP should be performed for SIH, and that EBP using small amounts of autologous blood is an effective treatment
