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Management of Spontaneous Intracranial Hypotension During Pregnancy: A Case Series
Author(s) -
Ferrante Enrico,
Trimboli Michele,
Petrecca Giuseppe,
Allegrini Francesco,
Ferrante Mirko Maria,
Rubino Fabio
Publication year - 2020
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13942
Subject(s) - medicine , epidural blood patch , spontaneous intracranial hypotension , bed rest , intracranial hypotension , complication , pregnancy , cerebrospinal fluid , surgery , anesthesia , conservative treatment , lumbar puncture , thrombosis , intracranial pressure , conservative management , biology , genetics
Background Spontaneous intracranial hypotension (SIH) is a rare condition resulting from cerebrospinal fluid (CSF) volume depletion, nearly always from spontaneous CSF leaks. CSF pressure in SIH is usually normal; low CSF pressure is found in a substantial minority of patients. SIH is uncommonly described in pregnancy. Case Series Five women with SIH during pregnancy have been conservatively treated adopting bed rest and overhydration. After prolonged conservative treatment, only 1 patient showed complete symptoms resolution. A rare SIH complication as cerebral venous thrombosis has been reported in 1 case. All 4 remaining patients had lumbar epidural blood patch (EBP) with symptoms disappearance. Conclusions EBP might be proposed to SIH patients also during pregnancy and after a brief period (~10 days) of ineffective conservative treatment, because it could allow faster symptoms improvement and complete recovery. Furthermore, EBP would avoid prolonged bed rest with the risk of SIH severe complications.