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

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• 作者：Keiji Hashizume ; Keisuke Watanabe ; Masahiko Kawaguchi ; Aki Fujiwara ; Hitoshi Furuya
• 关键词：Spontaneous intracranial hypotension ; Subdural hematoma ; Epidural blood patch
• 刊名：Clinical Neurology and Neurosurgery
• 出版年：2013
• 出版时间：August, 2013
• 年：2013
• 卷：115
• 期：8
• 页码：1403-1406
• 全文大小：351 K

文摘

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.