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http://dx.doi.org/10.17245/jdapm.2018.18.4.255

Epidural blood patch treatment of diplopia that developed after headache resolution in a patient with spontaneous intracranial hypotension  

Lee, Myung-Su (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Lee, Sookyung (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Seo, Dong-Kyun (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Yoon, Syn-Hae (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Choi, Seong-Soo (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.18, no.4, 2018 , pp. 255-259 More about this Journal
Abstract
Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.
Keywords
Abducens Nerve Palsy; Diplopia; Epidural Blood Patch; Spontaneous Intracranial Hypotension;
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1 Ko HC, Jung JK, Moon HS, Song JH, Eum SH, Cha YD. Treatment of spontaneous intracranial hypotension with multiple leakage sites of cerebrospinal fluid : A case report. Anesth Pain Med 2008; 3: 330-3.
2 Kong DS, Park K, Nam DH, Lee JI, Kim ES, Kim JS, et al. Atypical spontaneous intracranial hypotension (SIH) with nonorthostatic headache. Headache 2007; 47: 199-203.   DOI
3 Schievink WI, Maya MM, Louy C, Moser FG, Tourje J. Diagnostic criteria for spontaneous spinal CSF leaks and intracranial hypotension. AJNR Am J Neuroradiol 2008; 29: 853-6.   DOI
4 Schievink WI, Louy C. Precipitating factors of spontaneous spinal CSF leaks and intracranial hypotension. Neurology 2007; 69: 700-2.   DOI
5 Mokri B, Maher CO, Sencakova D. Spontaneous CSF leaks: underlying disorder of connective tissue. Neurology 2002; 58: 814-6.   DOI
6 Bechard P, Perron G, Larochelle D, Lacroix M, Labourdette A, Dolbec P. Case report: epidural blood patch in the treatment of abducens palsy after a dural puncture. Can J Anaesth 2007; 54: 146-50.   DOI
7 Khemka S, Mearza AA. Isolated sixth nerve palsy secondary to spontaneous intracranial hypotension. Eur J Neurol 2006; 13: 1264-5.   DOI
8 Russo A, Tessitore A, Cirillo M, Giordano A, De Micco R, Bussone G, et al. A transient third cranial nerve palsy as presenting sign of spontaneous intracranial hypotension. J Headache Pain 2011; 12: 493-6.   DOI
9 Paldino M, Mogilner AY, Tenner MS. Intracranial hypotension syndrome: a comprehensive review. Neurosurg Focus 2003; 15: ECP2.
10 Schievink WI. Spontaneous spinal cerebrospinal fluid leaks. Cephalalgia 2008; 28: 1345-56.   DOI
11 Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 2006; 295: 2286-96.   DOI
12 Zada G, Solomon TC, Giannotta SL. A review of ocular manifestations in intracranial hypotension. Neurosurg Focus 2007; 23: E8.
13 Kim YA, Yoon DM, Yoon KB. Epidural Blood Patch for the Treatment of Abducens Nerve Palsy due to Spontaneous Intracranial Hypotension - A Case Report. Korean J Pain 2012; 25: 112-5.   DOI
14 Berroir S, Loisel B, Ducros A, Boukobza M, Tzourio C, Valade D, et al. Early epidural blood patch in spontaneous intracranial hypotension. Neurology 2004; 63: 1950-1.   DOI
15 Sencakova D, Mokri B, McClelland RL. The efficacy of epidural blood patch in spontaneous CSF leaks. Neurology 2001; 57: 1921-3.   DOI