RESUMEN

A 41-year-old woman was admitted to the internal medicine department to assess incapacitating postural headache. Clinical findings suggested the need for computed tomography and nuclear magnetic resonance scanning of the head, which led to a diagnosis of spontaneous intracranial hypotension syndrome. Later, isotopic cysternography and nuclear magnetic resonance imaging of the spine were used unsuccessfully to try to locate the cerebrospinal fluid leak that caused the syndrome. When conservative treatment proved ineffective, the pain clinic was called in to perform an epidural blood patch procedure. The patch led to an improvement in symptoms and the syndrome resolved completely after a second lumbar blood patch was used.

Asunto(s)

Parche de Sangre Epidural , Hipotensión Intracraneal/terapia , Adulto , Femenino , Humanos , Hipotensión Intracraneal/diagnóstico

RESUMEN

Paciente mujer de 41 años que ingresó en el servicio de Medicina Interna para estudio de cefalea postural invalidante. Ante los hallazgos clínicos se le realizó una tomografía axial computerizada y resonancia magnética nuclear craneales llegando al diagnóstico de síndrome de hipotensión intracraneal espontáneo. Posteriormente se intentó localizar el punto de fuga de líquido cefalorraquídeo causante del síndrome mediante cisternografía isotópica y resonancia magnética nuclear de columna sin éxito. El tratamiento conservador resultó ineficaz y se solicitó la colaboración de la unidad de dolor para la realización de un parche hemático epidural. La aplicación de un parche epidural a nivel dorsal mejoró los síntomas, que se resolvieron definitivamente tras un segundo parche a nivel lumbar

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A 41-year-old woman was admitted to the internal medicine department to assess incapacitating postural headache. Clinical findings suggested the need for computed tomography and nuclear magnetic resonance scanning of the head, which led to a diagnosis of spontaneous intracranial hypotension syndrome. Later, isotopic cysternography and nuclear magnetic resonance imaging of the spine were used unsuccessfully to try to locate the cerebrospinal fluid leak that caused the syndrome. When conservative treatment proved ineffective, the pain clinic was called in to perform an epidural blood patch procedure. The patch led to an improvement symptoms and the syndrome resolved completely after a second lumbar blood patch was used

Asunto(s)

Femenino , Adulto , Humanos , Hipotensión Intracraneal/diagnóstico , Parche de Sangre Epidural , Medicina Interna/organización & administración , Medicina de Emergencia , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Cefalea , Punción Espinal , Antibacterianos/administración & dosificación , Presión del Líquido Cefalorraquídeo/fisiología