자발성 두개내 저압환자의 경막외 혈액봉합술 치험 2예

• Published in: The Korean journal of pain Vol. 12; no. 1; pp. 152 - 156
• Main Authors: 조성경, Sung Kyoung Cho, 주현철, Hyun Chul Joo, 박찬
• Format: Journal Article
• Language: Korean
• Published: 대한통증학회 1999
• Subjects: Pain: spontaneous intracranial hypotension; Technique: epidural blood patch; headache
• ISSN: 2005-9159; 1226-2579; 2093-0569

Spontaneous intracranial hypotension (SIH) is a rare syndrome which causes postural headache as- sociated with low cerebrospinal fluid (CSF) pressure, without preceding events such as lumbar puncture, back trauma, operative procedure or illness. The headche is usually accompanied by nausea, vomiting, tinnitus, neck stiffness, vertigo, photophobia and in rare cases diplopia, transient visual obscuration. Brain MRI may show subdural effusion, downward displacement of brain and diffuse and continuous meningeal enhancement when enhanced by gadolinium. Low opening pressure was shown through lumbar puncture. The value of protein and cell count of CSF may be slightly elevated. This syndrome usually resolves itself spontaneously or with strict bed rest. When the headache is persistent or incapacitating, more aggressive treatment may be necessary. We treated two cases of SIH in which epidural blood patch produced immediate and complete relief of the symptoms.