Open AccessSuccessful Treatment of Spontaneous Cerebrospinal Fluid Leak Headache With Fluoroscopically Guided Epidural Blood Patch: A Report of Four Cases
Author(s) -
Hayek Salim M.,
Fattouh Maher,
Dews Teresa,
Kapural Leonardo,
Malak Osama,
Mekhail Nagy
Publication year - 2003
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2003.03037.x
Subject(s) - epidural blood patch , medicine , leak , headaches , cerebrospinal fluid , cerebrospinal fluid leak , anesthesia , surgery , conservative management , spontaneous intracranial hypotension , pathology , environmental engineering , engineering
Spontaneous cerebrospinal fluid (CSF) leak is a rare clinical entity that may result in disabling headaches. It occurs as a result of dural defects, and the initial symptoms resemble those of postdural puncture headache. However, the positional headache can later evolve into a persistent chronic daily headache. The diagnosis of spontaneous CSF leak can be very challenging, but increasing awareness and improved diagnostic techniques are yielding ever more cases. When conservative management fails, the pain management clinician is called upon to administer an epidural blood patch. The success of this technique is dependent upon accurate diagnosis of the site of leakage and targeted epidural administration of the blood patch to this area. In this report, we describe four consecutive cases that were referred to our pain management department over an 18‐month period and were successfully treated with site‐directed epidural blood patches.