Abstract
Introduction: Intracranial hypotension is a pathology caused by low spinal fluid pressure due to leakage of spinal fluid, and is characterized by orthostatic headache. It is most commonly seen after trauma or lumbar puncture, but minor trauma can be a cause. In this article, we report a case of intracranial hypotension induced by use of a home massage machine in an unusual way.
Case: A 48–year–old–female, who mistakenly used a home–use massage machine for her lower back and lower legs upside–down (from her chest back to her lower back), arrived our hospital with a strong orthostatic headache. Based on the symptoms, intracranial hypotension was considered, and the patient was admitted to the hospital.
Progress: On the day of admission, treatment with bed rest and supplemental fluid was started. A full spine MRI revealed an enlarged epidural space and spinal fluid leakage in the backward of 7th cervical vertebra to the 9th thoracic vertebra. A contrast–enhanced brain MRI showed diffuse contrast enhancement of the thickened dura mater, and a diagnosis of intracranial hypotension was made. Since the symptoms did not improve with conservative treatment, blood patch therapy was performed via lumbar puncture on the 15th day of admission. The symptoms disappeared on the day after the surgery, and the patient was able to leave the hospital on the 20th day.
Conclusion: We experienced very rare case of intracranial hypotension caused by use of home-use massage machine in an unusual way. Symptoms were dramatically improved by early epidural blood patch.
