Korean J Anesthesiol.  2004 Jul;47(1):118-121. 10.4097/kjae.2004.47.1.118.

Two Cases of Spontaneous Intracranial Hypotension with Subdural Hematoma

• Choe WJ
• Choe JH
• Kim JW
• Cho YJ

• KMID: 2237570
• DOI: http://doi.org/10.4097/kjae.2004.47.1.118

Abstract

Spontaneous intracranial hypotension (SIH) is an uncommon disease which present as a spontaneously occurring postural headache. Diagnosis is supported by a low CSF pressure by lumbar puncture, diffuse dural enhancement on gadolinium-enhanced brain MRI, or by a CSF leakage site on a radioisotope cisternography or by computed tomographic myelography. Usually SIH treatment is conservative but often requires caffeine, steroids, continuous epidural saline infusion and an epidural blood patch. The most important complication of SIH is bilateral subdural hematoma (SDH), because it may require urgent neurosurgical intervention. We experienced two-cases of SIH with SDH treated with an epidural blood patch, but subdural hematoma increased after radioisotope cisternography, so burr hole drainage was performed with another epidural blood patch.

Keyword

epidural blood patch; radioisotope cisternography; spontaneous intracranial hypotension; subdural hematoma

MeSH Terms

Blood Patch, Epidural
Brain
Caffeine
Diagnosis
Drainage
Headache
Hematoma, Subdural*
Intracranial Hypotension*
Magnetic Resonance Imaging
Myelography
Spinal Puncture
Steroids
Caffeine
Steroids