{"title":"快速有效治疗自发性脑脊液漏致颅内低血压及衰弱性直立性头痛","authors":"H. Jacobs","doi":"10.15406/MOJCR.2020.10.00338","DOIUrl":null,"url":null,"abstract":"We are reporting a case series describing clinical, laboratory, MRI and CT myelogram imaging and treatment results for 4 patients with spontaneous cerebral spinal fluid (CSF) leak with subsequent intracranial hypotension; all of which resolved via blood patches. A 33-year-old woman (case 1) presented abrupt onset severe pain in the back and head; without preceding trauma or procedure. MRI brain revealed leptomeningeal enhancement, after CT myelogram identifying a CSF leak she received a 20ml epidural blood patch in the lumbar area. By the next day her symptoms had completely resolved. A 36year old woman (case 2) with 1 year-long history of positional headaches. Her CT Myelogram showed frequent multilevel Tarlov Cysts; one of which displayed leakage. Her orthostatic headaches disappeared after repeated EBP. A middle aged male (case 3) had an acute onset headache which persisted with orthostatic features since 6 weeks. He had complete remission after one epidural patching. A 47 year old man (case 4) presented with 5 days of typical orthostatic headaches, CT Myelogramm demonstrated a leaking thoracolumbar cyst. He required 2 EBP within 3 days to completely recover. Our cases support the notion that blood patching is a fast, effective and safe treatment for an increasingly recognized diagnosis of orthostatic headache caused by spontaneous intracranial hypotension.","PeriodicalId":93339,"journal":{"name":"MOJ clinical & medical case reports","volume":"10 1","pages":"36-39"},"PeriodicalIF":0.0000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fast effective treatment of spontaenous CSF leak causing intracranial hypotension and debilitating orthostatic headache\",\"authors\":\"H. Jacobs\",\"doi\":\"10.15406/MOJCR.2020.10.00338\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"We are reporting a case series describing clinical, laboratory, MRI and CT myelogram imaging and treatment results for 4 patients with spontaneous cerebral spinal fluid (CSF) leak with subsequent intracranial hypotension; all of which resolved via blood patches. A 33-year-old woman (case 1) presented abrupt onset severe pain in the back and head; without preceding trauma or procedure. MRI brain revealed leptomeningeal enhancement, after CT myelogram identifying a CSF leak she received a 20ml epidural blood patch in the lumbar area. By the next day her symptoms had completely resolved. A 36year old woman (case 2) with 1 year-long history of positional headaches. Her CT Myelogram showed frequent multilevel Tarlov Cysts; one of which displayed leakage. Her orthostatic headaches disappeared after repeated EBP. A middle aged male (case 3) had an acute onset headache which persisted with orthostatic features since 6 weeks. He had complete remission after one epidural patching. A 47 year old man (case 4) presented with 5 days of typical orthostatic headaches, CT Myelogramm demonstrated a leaking thoracolumbar cyst. He required 2 EBP within 3 days to completely recover. Our cases support the notion that blood patching is a fast, effective and safe treatment for an increasingly recognized diagnosis of orthostatic headache caused by spontaneous intracranial hypotension.\",\"PeriodicalId\":93339,\"journal\":{\"name\":\"MOJ clinical & medical case reports\",\"volume\":\"10 1\",\"pages\":\"36-39\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"MOJ clinical & medical case reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15406/MOJCR.2020.10.00338\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"MOJ clinical & medical case reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15406/MOJCR.2020.10.00338","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Fast effective treatment of spontaenous CSF leak causing intracranial hypotension and debilitating orthostatic headache
We are reporting a case series describing clinical, laboratory, MRI and CT myelogram imaging and treatment results for 4 patients with spontaneous cerebral spinal fluid (CSF) leak with subsequent intracranial hypotension; all of which resolved via blood patches. A 33-year-old woman (case 1) presented abrupt onset severe pain in the back and head; without preceding trauma or procedure. MRI brain revealed leptomeningeal enhancement, after CT myelogram identifying a CSF leak she received a 20ml epidural blood patch in the lumbar area. By the next day her symptoms had completely resolved. A 36year old woman (case 2) with 1 year-long history of positional headaches. Her CT Myelogram showed frequent multilevel Tarlov Cysts; one of which displayed leakage. Her orthostatic headaches disappeared after repeated EBP. A middle aged male (case 3) had an acute onset headache which persisted with orthostatic features since 6 weeks. He had complete remission after one epidural patching. A 47 year old man (case 4) presented with 5 days of typical orthostatic headaches, CT Myelogramm demonstrated a leaking thoracolumbar cyst. He required 2 EBP within 3 days to completely recover. Our cases support the notion that blood patching is a fast, effective and safe treatment for an increasingly recognized diagnosis of orthostatic headache caused by spontaneous intracranial hypotension.