J Korean Pain Soc.  1997 May;10(1):104-108.

Three Cases of Spontaneous Intracranial Hypotension ( SIH ) Treated with Epidural Blood Patch

• Shin JW
• Yun CS
• Lee C

Abstract

Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most char- acteristic symptom is an occipital or frontal headache which is aggrevated in the erect position and relieved in the supine position. This syndmme usually resolves spontaneously or with strict bed rest. When the headach persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. Epidural blood produces an organized clot which effectively tamponade any dural CSF leak The rapid relief of headache immediately after the infusion of blood occur by some other mechanism, such as an increase in subarachnoid pressure that is known to occur with infusion of fluid into the lumbar epidural Space. We report three cases of spontaneous intracranial hypotension successfully treated with epidural blood patch.

Keyword

Anesthetic techniques, epidural blood patch; Headache, spontaneous intracranial hypotension

MeSH Terms

Bed Rest
Blood Patch, Epidural*
Epidural Space
Headache
Intracranial Hypotension*
Intracranial Pressure
Spinal Puncture
Supine Position
Surgical Procedures, Operative