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Korean Journal of Anesthesiology 2004;47(1):118-121.
DOI: https://doi.org/10.4097/kjae.2004.47.1.118   
Two Cases of Spontaneous Intracranial Hypotension with Subdural Hematoma.
Won Joo Choe, Ji Hyun Choe, Jung Won Kim, Yong Jin Cho
1Departments of Anesthesiology and Pain Medicine,College of Medicine, Inje University, Ilsan, Korea. humal@ilsanpaik.ac.kr
2Departments of Neurology, College of Medicine, Inje University, Ilsan, Korea.
Spontaneous intracranial hypotension (SIH) is an uncommon disease which present as a spontaneously occurring postural headache. Diagnosis is supported by a low CSF pressure by lumbar puncture, diffuse dural enhancement on gadolinium-enhanced brain MRI, or by a CSF leakage site on a radioisotope cisternography or by computed tomographic myelography. Usually SIH treatment is conservative but often requires caffeine, steroids, continuous epidural saline infusion and an epidural blood patch. The most important complication of SIH is bilateral subdural hematoma (SDH), because it may require urgent neurosurgical intervention. We experienced two-cases of SIH with SDH treated with an epidural blood patch, but subdural hematoma increased after radioisotope cisternography, so burr hole drainage was performed with another epidural blood patch.
Key Words: epidural blood patch; radioisotope cisternography; spontaneous intracranial hypotension; subdural hematoma


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