Epidural blood patch improves postdural puncture headache in a patient with benign intracranial hypertension

Benign intracranial hypertension (BIH) is a disorder of elevated resting intracranial pressure without associated intracranial abnormality. When medical therapy fails to halt visual impairments or recalcitrant headaches progress, lumbar dural puncture and cerebral spinal fluid (CSF) drainage procedures are instituted. The authors report on a patient with BIH in whom a severe postdural puncture headache (low CSF pressure syndrome) paradoxically developed after therapeutic CSF drainage. This postdural puncture headache was successfully treated with an epidural blood patch without complicating the patient's underlying BIH condition.