Rebound Intracranial Hypertension: A Complication of Epidural Blood Patching for Intracranial Hypotension

American Journal of Neuroradiology

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Fig 1.
A, Patients presenting with intracranial hypotension most commonly – although not exclusively – complain of headaches in the occipital region. B, Patients who develop rebound intracranial hypertension often have a change in headache location, most commonly having headaches in a frontal, peri-orbital, or retro-orbital location.

Pre- and post-EBP characteristics of patients with RIH

Patient	Opening Pressure (cm H₂O)		Time from EBP to Repeat LP	Headache Location		Post-EBP N/V^{^a}	Post-EBP Blurred Vision	Patching Agent	Patch Volume	Duration of Acetazolamide Treatment
Patient	Pre-EBP	Post-EBP	Time from EBP to Repeat LP	Pre-EBP	Post-EBP	Post-EBP N/V^{^a}	Post-EBP Blurred Vision	Patching Agent	Patch Volume	Duration of Acetazolamide Treatment
1	6.8	25.5	6 hours	Occipital	Frontal	Yes	Yes	Fibrin glue	6 mL	5 days
2	N/A	28.0	3 weeks	Retro-orbital	Peri-orbital	No	No	Blood	18 mL	–^{^b}
3	12.3	31.0	2 hours	Retro-orbital	Retro-orbital	Yes	No	Blood + fibrin glue	16 mL	5 days
4	7.8	31.0	24 hours	Occipital	Holocephalic	Yes	Yes	Blood	18 mL	6 weeks
5	1.0	>55.0	2 hours	Holocephalic	Holocephalic	Yes	Yes	Blood	6 mL	2 weeks
6	15.0	32.0	7 days	Occipital	Frontal	Yes	Yes	Blood	5 mL	3+ years
7	10.8	24.2	24 hours	Occipital	Frontal and peri-orbital	Yes	Yes	Blood	18 mL	4 weeks
8	7.0	22.0	48 hours	Occipital	Frontal	Yes	Yes	Blood	20 mL	6 weeks
9	8.0	22.0	12 months	Occipital	Occipital	Yes	Yes	Blood	42 mL	6 months