RT Journal Article
SR Electronic
T1 Emergent Image-Guided Treatment of a Large CSF Leak to Reverse “In-Extremis” Signs of Intracranial Hypotension
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1627
OP 1629
DO 10.3174/ajnr.A1157
VO 29
IS 9
A1 Lasboo, A.A.
A1 Hurley, M.C.
A1 Walker, M.T.
A1 Surdell, D.
A1 Song, J.K.
A1 Rosenow, J.M.
A1 Shaibani, A.
YR 2008
UL http://www.ajnr.org/content/29/9/1627.abstract
AB SUMMARY: 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.