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Clin Neurol Neurosurg. 2013 Aug;115(8):1403-6. doi: 10.1016/j.clineuro.2013.01.022. Epub 2013 Feb 23.

Evaluation on a clinical course of subdural hematoma in patients undergoing epidural blood patch for spontaneous cerebrospinal fluid leak.

Author information

1
Department of Anesthesiology and Pain Medicine, Nara Medical University, Kashihara, Nara, Japan. kzume@naramed-u.ac.jp

Abstract

OBJECTIVE:

Subdural hematoma (SDH) is a frequent complication of spontaneous intracranial hypotension (SIH), in which epidural blood patch (EBP) may be applied as a treatment to stop cerebrospinal fluid (CSF) leak. However, a clinical course of SDH in SIH patients has not been sufficiently evaluated. We retrospectively evaluated the temporal relationships between EBP and SDH in the patients with SIH.

METHODS:

Twenty-nine consecutive patients, diagnosed as SIH, were studied. Clinical records and images were retrospectively evaluated. When orthostatic headache continued for 2 weeks regardless of conservative treatment, EBP was performed under fluoroscopy.

RESULTS:

We detected 13(45%) cases of SDH (mean age 44 years, 8 males and 5 females). In 6 patients, SDHs disappeared after effective EBP, i.e., after the disappearance of orthostatic headache. In 3 patients, SDHs were enlarged or recurred after effective EBP, and in 4 patients, SDHs were first detected after effective EBP.

CONCLUSION:

The knowledge of the presence of these types of SDH (enlarged or recurred or detected after EBP) may deserve clinical attention.

KEYWORDS:

Epidural blood patch; Spontaneous intracranial hypotension; Subdural hematoma

PMID:
23462186
DOI:
10.1016/j.clineuro.2013.01.022
[Indexed for MEDLINE]
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