Abstract

Spontaneous intracranial hypotension (SIH) occurs without any preceding events such as lumbar puncture, surgery, trauma, or medical illness. It is characterized by a postural headache that is aggravated in the erect or sitting position, and relieved in the supine position. A postural headache usually resolves either spontaneously or with conservative treatment. An autologous epidural blood patch (EBP) is an effective strategy for managing a postural headache that persists or is aggravated despite conservative treatments. We report a case of SIH with confirmed cerebrospinal fluid (CSF) leakage at the thoracic level, which was managed successfully with an autologous EBP at the lumbar and thoracic levels. We believe that success rate of an epidural blood patch in these cases is dependent on the approximation of the blood injection to the leak site.

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