Case Report
Volume 12 Issue 5 - 2020
Spontaneous Intracranial Hypotension Syndrome: An Unknown and Benign Condition
Bruno L Pessoa1*, Marco Antônio C Resende2, Marco Antônio Orsini Neves2, Brian França dos Santos2, Marco Antônio Alves Azizi2, Eduardo Jorge C da Silva2, Mauricio de Sant' anna Junior2, Julio Guilherme Silva2, Luciana Moises Camilo2, Carlos Eduardo Cardoso3 and Adalgiza Mafra Moreno4
1Department of Neurosurgery, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
2Service of Anesthesiology, Department of Surgery, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
3Vassouras University,Brazil
4Iguaçu University, Brazil
*Corresponding Author: Bruno L Pessoa, Department of Neurosurgery, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
Received: March 19, 2020; Published: April 15, 2020


Background: Spontaneous intracranial hypotension (SIH) is considered to be an uncommon disease caused by cerebrospinal fluid leakage. It is characterized by an orthostatic headache without history in the past of trauma or dural puncture. There is no consensus about level, volume and number of epidural blood patch (EBP) for SIH treatment in literature.

Methods: Our objective was to report a 38-year-old woman with SIH at two different levels (lumbar and cervical) as demonstrated by spine MRI and SPECT CT, treated by single lumbar low-volume EBP.

Results: The patient achieved good symptoms relief, with complete remission of headache, nausea and vomits. Besides, no complications occurred as consequence of the procedure and the discharged happened two days afterwards.

Conclusion: In spite of low volume used in the blood patch and of the existence of another CSF leak in a distant site, it is possible to obtain good results and at same time, to minimize complications due to higher blood volume patches application.

Keywords: Spontaneous Intracranial Hypotension; Epidural Blood Patch; Headache


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  3. Beleña J., et al. “Spontaneous intracranial hypotension syndrome treated with a double epidural blood patch”. Acta Anaesthesiologica Scandinavica 56 (2012): 1332-1335.
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  12. Franzini A., et al. “Spontaneous intracranial hypotension syndrome: a novel speculative physiopathological hypothesis and a novel patch method in a series of 28 consecutive patients”. Journal of Neurosurgery 112 (2010): 300-306.
  13. Ferrante E., et al. “Epidural blood patch in Trendelenburg position premedicated with acetazolamide to treat spontaneous intracranial hypotension”. European Journal of Neurology 17 (2010): 715-719.
  14. Griauzde J., et al. “Large-volume blood patch to multiple sites in the epidural space through a single-catheter access site for treatment of spontaneous intracranial hypotension”. American Journal of Neuroradiology 9 (2014): 1841-1846.
Citation: Bruno L Pessoa., et al. “Spontaneous Intracranial Hypotension Syndrome: An Unknown and Benign Condition”. EC Neurology 12.5 (2020): 27-33.

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