Greater Occipital Nerve Block as a Tool to Diagnose Spontaneous Intracranial Hypotension Before Epidural Blood Patch: A Case Report. Issue 1 (1st January 2020)

• Record Type: Journal Article
• Authors: Bortolato, Andrea; Simonato, Davide; Garrì, Federica; Gabrieli, Joseph Domenico; Cester, Giacomo; Causin, Francesco; Feltracco, Paolo
• Is Part Of: A & A practice. Volume 14:Issue 1(2020)
• Publication Date: 2020-01-01
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000001126
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : Spontaneous intracranial hypotension (SIH) has been increasingly characterized in recent years. A definitive diagnostic algorithm remains controversial because several symptoms are often found to be nonspecific. When neuroimaging fails to identify a cerebrospinal fluid leak and symptoms are atypical, an epidural blood patch (EBP) may be performed but not without risks. Our case shows how greater occipital nerve block (GONB) can expedite SIH diagnosis in a man with atypical presentation by reducing the sensory input from the posterior cranial fossa. The relief provided by GONB allowed to diagnose SIH promptly and the patient underwent a curative EBP.