From the Department of Neurology, Karolinska Hospital, Stockholm, Sweden (Dr. Hannerz); Department of Anaesthesiology, Karolinska Hospital, Stockholm, Sweden (Drs. Dahlgren and Irestedt); Department of Neurosurgery, Karolinska Hospital, Stockholm, Sweden (Dr. Meyerson); and Department of Neuroradiology, Karolinska Hospital, Stockholm, Sweden (Dr. Ericson)
Treatment of Idiopathic Intracranial Hypotension: Cervicothoracic and Lumbar Blood Patch and Peroral Steroid Treatment
Article first published online: 21 MAR 2006
Headache: The Journal of Head and Face Pain
Volume 46, Issue 3, pages 508–511, March 2006
How to Cite
Hannerz, J., Dahlgren, G., Irestedt, L., Meyerson, B. and Ericson, K. (2006), Treatment of Idiopathic Intracranial Hypotension: Cervicothoracic and Lumbar Blood Patch and Peroral Steroid Treatment. Headache: The Journal of Head and Face Pain, 46: 508–511. doi: 10.1111/j.1526-4610.2006.00383.x
- Issue published online: 21 MAR 2006
- Article first published online: 21 MAR 2006
- Accepted for publication August 10, 2005.
- idiopathic intracranial hypotension;
- extradural blood patch
Methods.—Twelve consecutive patients with clinical symptoms and testing results compatible with a diagnosis of idiopathic intracranial hypotension (IIH), but no identifiable site of cerebrospinal fluid (CSF) leakage, were treated with a cervicothoracic or lumbar epidural “blood patch” (EBP) or orally administered steroids.
Results.—Prompt and complete relief from headache persisting for at least 4 months was attained in 3 of 4 treatments with cervicothoracic EBP, 2 of 15 with lumbar EBP, and 4 of 8 with steroids.
Conclusion.—These results suggest that in patients who presumably suffer from IIH and yet have no identifiable site of CSF leakage, the presumed leakage more often occurs at the cervicothoracic level than the lumbar. In addition, our experience suggests that some IIH patients may be treated effectively with oral steroids and a trial of such therapy may be considered as an alternative to EBP.