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Headache. 2009 Jul;49(7):1047-51. doi: 10.1111/j.1526-4610.2009.01450.x. Epub 2009 May 15.

A novel technique for treatment of intractable spontaneous intracranial hypotension: lumbar dural reduction surgery.

Author information

1
Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, CA 90048, USA.

Abstract

BACKGROUND AND OBJECTIVE:

Spontaneous intracranial hypotension has become a well-described cause of headache particularly among young and middle-aged individuals. Treatment of the underlying spinal cerebrospinal fluid (CSF) leak is effective in relieving symptoms in the vast majority of patients but symptoms may become refractory. The author describes a novel surgical technique to treat intractable spontaneous intracranial hypotension.

METHODS:

A lumbar laminectomy is performed, a strip of dura is resected, and the dural defect is closed. The resulting decrease in lumbar CSF volume is believed to increase intracranial CSF volume and pressure.

RESULTS:

The technique was utilized in a patient who suffered with intractable positional headaches because of a spinal CSF leak for 6 years in spite of numerous surgical and nonsurgical therapies. Significant improvement of symptoms was sustained during a 1-year period of follow-up.

CONCLUSION:

Dural reduction surgery may be considered in carefully selected patients with intracranial hypotension.

[Indexed for MEDLINE]

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