TITLE:
Clinical Status of Patients with Cerebrospinal Fluid Hypovolemia Treated with an Epidural Blood Patch
AUTHORS:
Takafumi Nishizaki, Norio Ikeda, Shigeki Nakano, Takanori Sakakura, Natsumi Fujii, Tomomi Okamura
KEYWORDS:
CSF Hypovolemia, Epidural Self-Blood Patch, Chronic Subdural Hematoma
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.5 No.4,
October
12,
2015
ABSTRACT: Objective: Use of an epidural self-blood patch (EBP) is the most effective form of therapy for patients with cerebrospinal fluid (CSF) hypovolemia. However, even if the symptoms are resolved, other clinical aspects of this condition frequently prevent patients resuming social activity. In the present study, we investigated the clinical course of patients with CSF hypovolemia after treatment with an EBP to assess the factors affecting return to work or school, and considered the treatment of patients with progressive chronic subdural hematoma. Patients and Results: We investigated a group of 10 patients with CSF hypovolemia. After initial application of an EBP, 8 of these patients were completely relieved of postural headache and associated symptoms, and the other 2 recovered after a second application. However, 3 patients who had cervical spondylosis or psychosis were still unable to return to work or school. Two patients who were forced to retire have potential for rehabilitation after EBP. One patient has recovered from the illness, but could not return to school due to persistent medical history of psychosis. These patients had suffered symptoms for a long period before EBP (mean, 17.8 months; range 7 months to 3 years) relative to those who were able to resume social activity (mean, 2.0 months; range 7 days to 5 months) (P