Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension

Abstract

BACKGROUND:

Epidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention.

OBJECTIVE:

In this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated.

METHODS

: Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024.

RESULTS:

The mean age of the fifty-nine patients at symptom onset was 40.8 $\pm$ 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 scans with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 $\pm$ 22.7 months.

CONCLUSION:

CT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.