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Targeted Anterior Cervical Epidural Blood Patch in a Patient with Spontaneous Intracranial Hypotension
Ravindra Singh Shekhawat1,2, Ming Hui Yong1,2, Si Ying Julienne Keong2
1Department of Neurology, National Neuroscience Institute-Singapore General Hospital, Singapore.
Abstract:
A 45-year-old male was admitted with severe orthostatic headache secondary to spontaneous intracranial hypotension. He had the site of cerebrospinal fluid (CSF) leakage identified at the anterolateral aspect of the C7-T1 spinal level. He first underwent a conventional posterior-approach cervical epidural blood patch (EBP) which provided immediate relief to the patient's symptoms; however, his symptoms recurred two days later. To better target the anterolateral leakage site, we employed an anterior-approach EBP under computed tomography (CT) guidance. After this attempt, the patient experienced complete relief of his symptoms, and the headache eventually resolved.
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