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Closing the Gap: A Case Report on a Blood Patch Solution for Cerebrospinal Fluid Leak
Guilherme Sousa1, Bárbara Alves1, Filipa Cunha1
1Anaesthesiology, Centro Hospitalar Tondela-Viseu, Viseu, PRT.
Cureus
|January 19, 2024
Summary
Spontaneous intracranial hypotension, caused by cerebrospinal fluid leaks, can lead to severe headaches. An epidural blood patch effectively treated a patient unresponsive to conservative measures, offering a promising intervention.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Spontaneous intracranial hypotension (SIH) arises from cerebrospinal fluid (CSF) leaks, disrupting intracranial pressure regulation.
- SIH is an infrequent cause of severe headaches with diverse symptoms, often leading to diagnostic delays and serious outcomes.
Observation:
- A 55-year-old woman presented with a three-month history of daily, severe headaches.
- Imaging revealed subdural collections, supporting the diagnosis of CSF hypotension.
- Conservative treatments, including rest, hydration, and medication, proved ineffective.
Findings:
- The patient underwent an epidural blood patch, a procedure involving injecting blood into the epidural space to seal CSF leaks.
- Following the procedure, the patient experienced progressive clinical improvement.
Implications:
- This case highlights the epidural blood patch as a potentially effective treatment for SIH and its complications, especially when conservative methods fail.
- It underscores the value of a multidisciplinary approach involving neurologists and anesthesiologists for managing SIH.
