Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report
Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF) and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Patients may present with headache, there may be low CSF pressure, or imaging evidence of CSF leak. Ep...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2025-03-01
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| Series: | Journal of Neuroanaesthesiology and Critical Care |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1790253 |
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| author | Dimple Shah Sanghita Layek Bibhukalyani Das |
| author_facet | Dimple Shah Sanghita Layek Bibhukalyani Das |
| author_sort | Dimple Shah |
| collection | DOAJ |
| description | Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF) and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Patients may present with headache, there may be low CSF pressure, or imaging evidence of CSF leak. Epidural blood patching (EBP) has been considered as the mainstay of therapy for SIH. We report a case of SIH with bilateral subdural hematoma in a 63-year-old female patient who presented with sudden-onset headache for 4 days without any history of loss of consciousness, vomiting, or seizures. Lumbar EBP was given and it resulted in improved clinical features, imaging findings, and increase in optic nerve sheath diameter (ONSD) when compared with ONSD before EBP administration. EBP produces a tamponade effect and its efficacy results from sealing the dural defect by the injected blood, thus stopping the CSF leak. |
| format | Article |
| id | doaj-art-3d80e7f91a6d490a9ffa1a486d6a1dcc |
| institution | Matheson Library |
| issn | 2348-0548 2348-926X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Neuroanaesthesiology and Critical Care |
| spelling | doaj-art-3d80e7f91a6d490a9ffa1a486d6a1dcc2025-07-18T22:58:31ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X2025-03-011201586010.1055/s-0044-1790253Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case ReportDimple Shah0Sanghita Layek1Bibhukalyani Das2Neuroanaesthesiology and Neurocritical Care, Institute of Neurosciences, Kolkata, West Bengal, IndiaNeuroanaesthesiology and Neurocritical Care, Institute of Neurosciences, Kolkata, West Bengal, IndiaNeuroanaesthesiology and Neurocritical Care, Institute of Neurosciences, Kolkata, West Bengal, IndiaSpontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF) and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Patients may present with headache, there may be low CSF pressure, or imaging evidence of CSF leak. Epidural blood patching (EBP) has been considered as the mainstay of therapy for SIH. We report a case of SIH with bilateral subdural hematoma in a 63-year-old female patient who presented with sudden-onset headache for 4 days without any history of loss of consciousness, vomiting, or seizures. Lumbar EBP was given and it resulted in improved clinical features, imaging findings, and increase in optic nerve sheath diameter (ONSD) when compared with ONSD before EBP administration. EBP produces a tamponade effect and its efficacy results from sealing the dural defect by the injected blood, thus stopping the CSF leak.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1790253epidural blood patchoptic nerve sheath diameterspontaneous intracranial hypotension |
| spellingShingle | Dimple Shah Sanghita Layek Bibhukalyani Das Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report Journal of Neuroanaesthesiology and Critical Care epidural blood patch optic nerve sheath diameter spontaneous intracranial hypotension |
| title | Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report |
| title_full | Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report |
| title_fullStr | Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report |
| title_full_unstemmed | Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report |
| title_short | Epidural Blood Patch in Spontaneous Intracranial Hypotension and Role of Optic Nerve Sheath Diameter: A Case Report |
| title_sort | epidural blood patch in spontaneous intracranial hypotension and role of optic nerve sheath diameter a case report |
| topic | epidural blood patch optic nerve sheath diameter spontaneous intracranial hypotension |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1790253 |
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