Radiological features of spontaneous intracranial hypotension (sih) and its management with lumbar epidural autologous blood patch: a case report

Author: 
Ranjit Meher and Anwesha D Patel

Spontaneous intracranial hypotension (SIH) is an important but one of the rarest causes of headache in young and middle- aged people. Its incidence is about five per 100,000 people [1], with peak at 40 years of age and twice more common in women than men. The classic symptom of SIH patient is postural or orthostatic headache which aggravates on standing position and is relieved on lying down position.
We reported a rare case of spontaneous intracranial hypotension (SIH) infourty year old gentleman who presented with classic symptoms of orthostatic hypotension. The patient was evaluated with computed tomography (CT), non-contrast & contrast enhanced magnetic resonance imaging (MRI). CT myelography confirmed the CSF leaks at multiple spinal nerve root levels.
The patient was treated with therapeutic lumbar epidural blood patch (LEBP) by injection of 10-20mL autologous blood into the epidural space when all available conservative treatments were failed. There was significant improvement of orthostatic headache of patients with in few days of LEBP.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2021.23827.4719
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