Treatment of idiopathic intracranial hypotension: cervicothoracic and lumbar blood patch and peroral steroid treatment

Headache
Jan HannerzKaj Ericson

Abstract

Twelve consecutive patients with clinical symptoms and testing results compatible with a diagnosis of idiopathic intracranial hypotension (IIH), but no identifiable site of cerebrospinal fluid (CSF) leakage, were treated with a cervicothoracic or lumbar epidural "blood patch" (EBP) or orally administered steroids. Prompt and complete relief from headache persisting for at least 4 months was attained in 3 of 4 treatments with cervicothoracic EBP, 2 of 15 with lumbar EBP, and 4 of 8 with steroids. These results suggest that in patients who presumably suffer from IIH and yet have no identifiable site of CSF leakage, the presumed leakage more often occurs at the cervicothoracic level than the lumbar. In addition, our experience suggests that some IIH patients may be treated effectively with oral steroids and a trial of such therapy may be considered as an alternative to EBP.

References

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Citations

Jun 6, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Bobby Mehta, Jordan Tarshis
Feb 20, 2013·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Farnaz AmoozegarWerner J Becker
Jul 1, 2015·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Shruti G Kapoor, Shihab Ahmed
May 15, 2008·Pain Practice : the Official Journal of World Institute of Pain·Baris BakirSuleyman Ozyalcin
Feb 18, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·P MartineauJai Shankar
Mar 12, 2013·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·V AgarwalW E Rothfus

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