Journal
JOURNAL OF NEUROSURGERY-SPINE
Volume 9, Issue 5, Pages 483-487Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/SPI.2008.9.11.483
Keywords
bilateral subdural hematoma; cervical dural tear; epidural blood patch; spontaneous intracranial hypotension
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The authors report the case of a 56-year-old previously healthy man who presented with a 4-month history of postural headache accompanied by nausea and vomiting. The results of initial imaging studies of the brain were normal. Repeated MR imaging demonstrated bilateral subdural hematomas which were drained and reaccumulated over a period of time. Spinal myelography revealed a cerebrospinal fluid leak at the C1-2 level. A cervical epidural blood patch, with repeated injections of 10 ml autologous blood at the site of the leak, dramatically improved the headache within 24 hours and eliminated the recurrent subdural hematomas. The results of follow-up computed tomography of the brain at 1, 4, 8, and 16 weeks were normal, and at 1-year follow-up the patient was completely free of symptoms and working. (DOI: 10.3171/SPI.2008.9.11.483)
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