The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A Case of Epidural Blood Patch to Treat Headache Due to Spontaneous Intracranial Hypotension -A case report-

경막외 혈액봉합술을 이용한 자연성 두개내 저압성 두통 환자의 치험 1예 -증례 보고-

  • Park, Soo-Seog (Department of Anesthesiology, Catholic University College of Medicine) ;
  • Jang, Yeon (Department of Anesthesiology, Catholic University College of Medicine) ;
  • Cho, Eun-Chung (Department of Anesthesiology, Catholic University College of Medicine) ;
  • Jee, Seung-Eun (Department of Anesthesiology, Catholic University College of Medicine) ;
  • Song, Ho-Kyung (Department of Anesthesiology, Catholic University College of Medicine) ;
  • Jung, Sung-Woo (Department of Neurology, Catholic University College of Medicine)
  • 박수석 (가톨릭대학교 의과대학 마취과학교실) ;
  • 장연 (가톨릭대학교 의과대학 마취과학교실) ;
  • 조은정 (가톨릭대학교 의과대학 마취과학교실) ;
  • 지승은 (가톨릭대학교 의과대학 마취과학교실) ;
  • 송호경 (가톨릭대학교 의과대학 마취과학교실) ;
  • 정성우 (가톨릭대학교 의과대학 신경과학교실)
  • Published : 1998.10.10
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Abstract

Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

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