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Computerized tomography-guided epidural blood patch in the treatment of spontaneous low cerebrospinal fluid pressure headache
Authors:Karst M  Hollenhorst J  Fink M  Conrad I
Affiliation:Department of Anesthesiology, Pain Clinic, Medical School of Hannover, D-30623 Hannover, Germany. Karst.Matthias@MH-Hannover.De
Abstract:
A 54-year-old woman suffering from migraine for 35 years was referred to the pain clinic with a changed pattern of headache that had developed over the last 6 weeks. The pain was located in the central forehead region; aggravation in the prone and immediate relief in the supine position led to the hypothesis of a spontaneous low cerebrospinal fluid (CSF) pressure headache. Cisternography revealed a cyst-like formation in the cervico-thoracic region, indicating cerebrospinal fluid leakage. Magnetic resonance imaging (MRI) myelography confirmed ventral leakage but failed to locate the exact site. Computerized tomography (CT)-guided epidural blood patching between T1 and T2 completely relieved the headache.
Keywords:Spontaneous low cerebrospinal fluid (CSF) pressure headache    Schaltenbrand's syndrome    CT-guided    epidural blood patch
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