Letter to the Editor. Epidural blood patch reversing acquired Chiari malformation due to chronic CSF leak

2019 ◽  
Vol 23 (4) ◽  
pp. 531-532
Author(s):  
Enrico Ferrante ◽  
Giuseppe Pontrelli
Keyword(s):  
Chiari Malformation ◽  
Epidural Blood Patch ◽  
Csf Leak ◽  
Letter To The Editor ◽  
Blood Patch

What is the actions mechanism of lumbar epidural blood patch in the treatment of the headache by spontaneous carvical CSF leak?

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 75
Author(s):  
I. Arpino ◽  
E. Ferrante ◽  
C. Guarnerio ◽  
A. Citterio ◽  
R. Sterzi
Keyword(s):  
Epidural Blood Patch ◽  
Csf Leak ◽  
Blood Patch

CT-guided epidural blood patch for treatment of CSF leak and pseudomeningocele following tethered cord release in a 3-year-old

2016 ◽  
Vol 40 (6) ◽  
pp. 1191-1194 ◽  
Author(s):  
Joshua Cornman-Homonoff ◽  
Andrew Schweitzer ◽  
J. Levi Chazen
Keyword(s):  
Epidural Blood Patch ◽  
Tethered Cord ◽  
Csf Leak ◽  
Ct Guided ◽  
Blood Patch

scholarly journals Spontaneous C1-2 CSF Leak Treated with High Cervical Epidural Blood Patch

2008 ◽  
Vol 35 (1) ◽  
pp. 102-105 ◽  
Author(s):  
Philip WH Peng ◽  
Richard Farb
Keyword(s):  
Epidural Blood Patch ◽  
Spontaneous Intracranial Hypotension ◽  
Memory Loss ◽  
Csf Leak ◽  
Cerebellar Tonsil ◽  
Iodinated Contrast ◽  
Blood Patch ◽  
Magnetic Resonance Imaging Mri ◽  
Fluid Collections ◽  
High Cervical

Spontaneous intracranial hypotension (SIH) is a condition caused by spontaneous spinal cerebrospinal fluid (CSF) leaks. Clinically, it is characterized by orthostatic headache and may respond well to epidural blood patch. Other neurological presentations of SIH include diplopia, memory loss, hearing deficits, Parkinsonism, ataxia, obtundation and even coma.Magnetic resonance imaging (MRI) is crucial in the diagnosis of this condition. Typical radiological features include diffuse pachymeningeal enhancement, descent of the cerebellar tonsil, a decrease in the size of prepontine and perichiasmatic cisterns, and subdural fluid collections. However, radiological imaging such as radionuclide cisternography or spinal MRI are not reliable in detecting the site of leakage. Myelography with iodinated contrast followed by thin-cut computed tomography (CT) or MRI of the entire spine has been shown as the technique of choice in defining the location of the CSF leak.

scholarly journals Intracranial hypotension and hypertension: reversible Chiari malformation due to dynamic cerebrospinal fluid abnormalities in Gorham-Stout disease. Case report

2018 ◽  
Vol 22 (5) ◽  
pp. 508-512 ◽  
Author(s):  
Shoko Yoshimoto ◽  
Keisuke Takai ◽  
Koichi Takahashi ◽  
Toshio Yasui ◽  
Makoto Taniguchi
Keyword(s):  
Intracranial Hypotension ◽  
Chiari Malformation ◽  
Neurological Status ◽  
Orthostatic Headache ◽  
Csf Leak ◽  
Disease Case ◽  
Blood Patch ◽  
Visual Acuity Loss ◽  
Suboccipital Decompression ◽  
Fractures Of The Femur

Gorham-Stout disease (GSD) is an intractable disease characterized by massive osteolysis caused by abnormal lymphangiogenesis in bone. In rare cases of GSD, CSF abnormalities develop. The authors present the case of a 19-year-old woman with GSD presenting with orthostatic headache due to intracranial hypotension (5 cm H2O). The clinical course of this case was very unusual. Orthostatic headache was associated with a CSF leak from the thigh after pathological fractures of the femur and pelvis. The chronic CSF leak led to acquired Chiari malformation (CM) with syringomyelia. After an epidural blood patch, her neurological status improved; however, after the complete arrest of the CSF leak from the thigh, she presented with severe nonpostural headache and progressive visual acuity loss with optic papilledema. A ventriculoperitoneal shunt was placed to treat intracranial hypertension (50 cm H2O). Headache improved and optic papilledema decreased after shunt surgery. This case shows that dynamic CSF abnormalities may lead to reversible CM in patients with GSD. Sealing a CSF leak rather than performing suboccipital decompression is recommended for acquired CM resulting from a CSF leak.

Multiple Fibrin Glue Use in a Complicated Case of Postdural Puncture Headache Following Intrathecal Drug Delivery System Placement: A Case Report

2019 ◽  
pp. 77-81
Author(s):  
Matthew Chung
Keyword(s):  
Drug Delivery ◽  
Cerebrospinal Fluid ◽  
Drug Delivery System ◽  
Fibrin Glue ◽  
Delivery System ◽  
Epidural Blood Patch ◽  
Csf Leak ◽  
Postdural Puncture Headache ◽  
Intrathecal Drug Delivery ◽  
Blood Patch

A postdural puncture headache (PDPH) is a well-described complication after implantation of an intrathecal drug delivery system (IDDS). Treatment is typically with supportive management with the occasional need for an epidural blood patch. We describe a case of a patient with refractory muscle spasticity secondary to cerebral palsy that required a baclofen IDDS implantation and subsequently developed a PDPH. After failing conservative therapy as well as an epidural blood patch, the decision was made to attempt an epidural fibrin patch, which transiently improved her headache. Upon return of the patient’s symptoms, computed tomography myelogram demonstrated an extensive cerebrospinal fluid leak with ventral spread into the retroperitoneal space. Using a novel technique, a second epidural fibrin glue patch was administered just adjacent to the IDDS catheter insertion point, which was then successful in resolving her symptoms. Key words: Intrathecal drug delivery system, postdural puncture headache, dural tear, cerebrospinal fluid (CSF) leak, fibrin glue, epidural blood patch

Epidural blood patch in the treatment of headaches by spontaneous CSF leak

2006 ◽  
Vol 23 (Supplement 37) ◽  
pp. 218 ◽  
Author(s):  
I. Arpino ◽  
C. Guarnerio ◽  
E. Ferrante ◽  
A. Citterio ◽  
R. Wetzel
Keyword(s):  
Epidural Blood Patch ◽  
Csf Leak ◽  
Blood Patch

scholarly journals Peripartum Isolated Cortical Vein Thrombosis in a Mother with Postdural Puncture Headache Treated with an Epidural Blood Patch

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Etienne Laverse ◽  
Sarah Cader ◽  
Rajith de Silva ◽  
Sanjiv Chawda ◽  
Satish Kapoor ◽  
...  
Keyword(s):  
Epidural Blood Patch ◽  
Csf Leak ◽  
Postdural Puncture Headache ◽  
Mri Scan ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Blood Patch ◽  
Low Pressure Headache ◽  
Pressure Headache

A 32-year-old woman presented with low pressure headache 3 days after delivery of her baby. An assessment of postdural puncture headache was made. This was initially treated with analgesia, caffeine, and fluids for the presumed cerebrospinal fluid (CSF) leak. The woman was readmitted two days after her hospital discharge with generalised seizures. A brain scan showed features of intracranial hypotension, and she was treated for CSF leak using an epidural blood patch. Her symptoms worsened and three days later, she developed a left homonymous quadrantanopia. An MRI scan confirmed a right parietal haematoma with evidence of isolated cortical vein thrombosis (ICVT).

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