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Epidural Blood Patch for the Treatment of Spontaneous Intracranial Hypotension: A Case Series.
Gomez, Maria; Sharma, Manas; Chan, Tommy Lik Hang; Bellingham, Geoff; Chui, Jason.
Afiliación
  • Gomez M; Departments of Anesthesia & Perioperative Medicine.
  • Sharma M; Medical imaging.
  • Chan TLH; Lawson Research Institute.
  • Bellingham G; Lawson Research Institute.
  • Chui J; Clinical Neurological Science, University of Western Ontario and London Health Science Centre, London, ON, Canada.
J Neurosurg Anesthesiol ; 2024 Jul 19.
Article en En | MEDLINE | ID: mdl-39028304
ABSTRACT

BACKGROUND:

Epidural blood patch (EBP) is frequently used for the treatment of spontaneous intracranial hypotension (SIH) and anesthesiologists are often involved in performing such procedures. However, the optimal technique and approach of EBP remains uncertain.

METHODS:

This case series included adult patients with SIH who underwent EBPs at London Health Science Centre, Ontario, Canada between 2010 and 2022. Demographics, clinical presentations, investigations, and EBP treatment details were collected and analyzed. Univariate analysis was used to investigate the association of the variables with the likelihood of EBP 1-month efficacy and the efficacy duration of EBP.

RESULTS:

The study included 36 patients with SIH who received at least 1 EBP. EBPs provided immediate relief in almost all patients, albeit with diminishing effects over time. The 1-month efficacy improved with increasing number of EBP attempts (P=0.032, Fisher exact test), though no particular EBP technique or volume of injectate was associated with better efficacy (P=0.38, Fisher exact test). Though permanent resolution of symptoms was observed in only 24 of 82 EBPs (29%), 24 of 36 patients (67%) had permanent symptom resolution following repeated EBPs.

CONCLUSIONS:

EBP is a promising treatment and symptomatic relief option in patients suffering from the debilitating symptoms of SIH. Tailored EBP techniques, including use of targeted higher volume EBP and a multi-level catheter guided technique for refractory cases, showed efficacy in our institutional setting. Despite its limitations, this study contributes valuable insights and experiences into the use of EBP for treatment of SIH.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Neurosurg Anesthesiol Asunto de la revista: ANESTESIOLOGIA / NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Neurosurg Anesthesiol Asunto de la revista: ANESTESIOLOGIA / NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos