Emergent Image-Guided Treatment of a Large CSF Leak to Reverse "In-Extremis" Signs of Intracranial Hypotension

作者:La**oo A A; Hurley M C; Walker M T; Surdell D; Song J K; Rosenow J M; Shaibani A*
来源:American Journal of Neuroradiology, 2008, 29(9): 1627-1629.
DOI:10.3174/ajnr.A1157

摘要

We report the use of an emergent, targeted fibrin spinal epidural blood patch with subarachnoid saline infusion to rapidly reverse "in-extremis" clinical and imaging signs of posterior-fossa coning brought about by acute-on-chronic intracranial hypotension, itself consequent to a cervicothoracic CSF leak. Treatment resulted in a dramatic recovery and eventual discharge with return to normal lifestyle and occupation. The clinical and imaging danger signs are reviewed; fibrin patch technique and potential pitfalls in postprocedure management are analyzed.