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Computerized tomography-guided epidural blood patch in the treatment of spontaneous low cerebrospinal fluid pressure

M Karst1, J Hollenhorst, M Fink

  • 1Department of Anesthesiology, Pain Clinic, Medical School of Hannover, D-30623 Hannover, Germany. Karst.Matthias@MH-Hannover.De

Acta Anaesthesiologica Scandinavica
|April 20, 2001
PubMed

A 54-year-old woman suffering from migraine for 35 years was referred to the pain clinic with a changed pattern of headache that had developed over the last 6 weeks. The pain was located in the central forehead region; aggravation in the prone and immediate relief in the supine position led to the hypothesis of a spontaneous low cerebrospinal fluid (CSF) pressure headache. Cisternography revealed a cyst-like formation in the cervico-thoracic region, indicating cerebrospinal fluid leakage. Magnetic resonance imaging (MRI) myelography confirmed ventral leakage but failed to locate the exact site. Computerized tomography (CT)-guided epidural blood patching between T1 and T2 completely relieved the headache.

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