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Surgical "Fat Patch" Improves Secondary Intracranial Hypotension Orthostatic Headache Associated with Lumbosacral Dural Ectasia.
- Source :
-
World neurosurgery [World Neurosurg] 2017 Nov; Vol. 107, pp. 1053.e7-1053.e10. Date of Electronic Publication: 2017 Sep 01. - Publication Year :
- 2017
-
Abstract
- Background: Secondary intracranial hypotension is a clinical syndrome associated with reduction of cerebrospinal fluid volume and dural continuity violation. The main symptoms are orthostatic headache associated with nausea, vomiting, diplopia, dizziness, and tinnitus. The treatment is usually nonspecific.<br />Case Description: A 37-year-old woman developed secondary intracranial hypotension caused by lumbosacral iatrogenic dural ectasia following detethering surgery. An orthostatic headache was the mainstay of her clinical picture, and it was confirmed by intracranial pressure monitoring. Conservative treatment including spinal blood patch improved symptoms for a limited amount of time (<1 month). Altered compliance of the dural spinal sac was suspected. Therefore thecal sac remodeling by placing autologous fat at the level of the dural ectasia was performed, improving the symptoms for 2 years.<br />Conclusion: Volumetric reduction of the epidural space may be considered as a valuable therapeutic option in case of intracranial hypotension that is unresponsive to medical treatments and spinal blood patch, as well as when an altered compliance of the dural sac is hypothesized.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Cerebrospinal Fluid Leak complications
Cerebrospinal Fluid Leak diagnostic imaging
Dilatation, Pathologic complications
Dilatation, Pathologic diagnostic imaging
Dilatation, Pathologic therapy
Dura Mater diagnostic imaging
Female
Headache diagnostic imaging
Headache etiology
Humans
Intracranial Hypotension diagnostic imaging
Intracranial Hypotension etiology
Blood Patch, Epidural methods
Cerebrospinal Fluid Leak therapy
Headache therapy
Intracranial Hypotension therapy
Lumbosacral Region diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 107
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 28866058
- Full Text :
- https://doi.org/10.1016/j.wneu.2017.08.145