Spontaneous CSF leak treated with percutaneous CT-guided fibrin glue

Abstract

Gladstone et al.1 advocate sealing CSF leaks with CT-guided, targeted fibrin glue injections in patients with spontaneous intracranial hypotension (SIH). We agree that the injection should be made at the site of the leak as a distant epidural blood patch may often give only temporary relief. In our SIH patients, we obtained permanent sealing of the leak in 13 of 16 cases in which the CSF loss at a spinal root level was approached either by direct surgery (three successful cases) or by targeted percutaneous …