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Journal of Korean Neurosurgical Society 2011;50(3): 274-276.
doi: https://doi.org/10.3340/jkns.2011.50.3.274
Chronic Subdural Hematoma after Spontaneous Intracranial Hypotension : A Case Treated with Epidural Blood Patch on C1-2.
Byung Won Kim, Young Jin Jung, Min Su Kim, Byung Yon Choi
Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea. mogumns@daum.net
Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments including bed rest, hydration and analgesics. Magnetic resonance imaging showed a subdural hematoma in the bilateral fronto-parietal region, and computed tomography (CT) myelography showed a CSF leak originating at the C1-2 level. The patient underwent successful treatment with a CT-guided epidural blood patch at the CSF-leak site after trephination for bilateral SDH.
Key Words: Blood patch; Epidural; Intracranial hypotension; Subdural hematoma
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