Targeted epidural patch with n-butyl cyanoacrylate (n-BCA) through a single catheter access site for treatment of a cerebral spinal fluid leak causing spontaneous intracranial hypotension. (5th June 2015)

• Record Type: Journal Article
• Authors: Woolen, Sean; Gemmete, Joseph J; Pandey, Aditya S; Chaudhary, Neeraj
• Is Part Of: Journal of neurointerventional surgery. Volume 8:Number 7(2016)
• Page Start: e26
• Page End: e26
• Publication Date: 2015-06-05
• Subjects: Catheter -- Epidural -- Liquid Embolic Material -- Spine; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2015-011778.rep
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Spontaneous intracranial hypotension (SIH) usually occurs in the setting of a spontaneous cerebral spinal fluid (CSF) leak. We report the first description of a case of SIH caused by a CSF leak which improved after a targeted epidural patch with n-butyl cyanoacrylate (n-BCA) at the right T1–T2 level. An 81-year-old woman presented with an orthostatic headache for 6 days. MRI of the brain with contrast demonstrated low lying cerebellar tonsils, an engorged transverse sinus flow void, bifrontal small subdural fluid collections, and diffuse dural enhancement. CT myelography showed extravasation of intrathecal contrast at the right T1–T2 level. A targeted epidural patch was performed by injection of n-BCA through a catheter at the right T1–T2 level. After treatment, the patient's symptoms immediately improved and she was without a headache at 1-year follow-up.