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Treatment of Idiopathic Intracranial Hypotension: Cervicothoracic and Lumbar Blood Patch and Peroral Steroid Treatment
Author(s) -
Hannerz Jan,
Dahlgren Gunnar,
Irestedt Lars,
Meyerson Björn,
Ericson Kaj
Publication year - 2006
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/j.1526-4610.2006.00383.x
Subject(s) - medicine , epidural blood patch , lumbar , intracranial hypotension , cerebrospinal fluid , cerebrospinal fluid leakage , anesthesia , lumbar puncture , surgery
Methods.—Twelve consecutive patients with clinical symptoms and testing results compatible with a diagnosis of idiopathic intracranial hypotension (IIH), but no identifiable site of cerebrospinal fluid (CSF) leakage, were treated with a cervicothoracic or lumbar epidural “blood patch” (EBP) or orally administered steroids. Results.—Prompt and complete relief from headache persisting for at least 4 months was attained in 3 of 4 treatments with cervicothoracic EBP, 2 of 15 with lumbar EBP, and 4 of 8 with steroids. Conclusion.—These results suggest that in patients who presumably suffer from IIH and yet have no identifiable site of CSF leakage, the presumed leakage more often occurs at the cervicothoracic level than the lumbar. In addition, our experience suggests that some IIH patients may be treated effectively with oral steroids and a trial of such therapy may be considered as an alternative to EBP.