Title: Three sites of high-flow CSF leakage in spontaneous intracranial hypotension
Abstract: A 36-year-old previously healthy woman presented to our clinic complaining of a headache that had gradually evolved over the preceding 4 weeks. Associated symptoms were dizziness and reduced hearing bilaterally. The pain subsided within 2 minutes when she was recumbent. No trauma of the head or spine was reported. General physical and neurologic examinations on admission were normal. Lumbar puncture showed clear CSF (87 cells/mm3) and normal protein and glucose levels. Initial cranial MRI revealed diffuse dural contrast enhancement. Small subdural hygromas were seen bilaterally on a CT scan. Spontaneous intracranial hypotension (SIH) was assumed to be the cause of the patient's complaints. She was initially treated with oral caffeine (0.2 g TID), but as symptoms worsened, an epidural blood patch (EBP) at L3/4 level was performed (20 mL of autologous blood). As symptoms continued to exacerbate, more detailed investigations were performed.
A T1- and T2-weighted spinal MRI scan showed no engorged epidural veins or extradural CSF collections. Standard CSF scintigraphy performed 4 and 24 hours after injection of 21 MBq of 111In-diethylenetriamine pentaacetic acid (DTPA) into the subarachnoid space via lumbar puncture …
Publication Year: 2006
Publication Date: 2006-03-13
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 7
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