Intracranial hypotension headache caused by a massive cerebrospinal fluid leak successfully treated with a targeted c2 epidural blood patch: a case report.

摘要: Cervical epidural steroid injections, administered either interlaminarly or transforaminally, are common injection therapies used in many interventional pain management practices to treat cervicalgia cervicobrachial secondary spondylosis intervertebral disc displacement of the cervical spine. Among risks associated with these procedures risk for inadvertent dural puncture and development positional headache from intracranial hypotension. We report case a 31-year-old woman history migraine spine degenerative disease that developed an intractable orthostatic accompanied by nausea vomiting after therapeutic high intralaminar was directly C1-C2 spinal level. Although initial magnetic resonance imaging brain unremarkable, computed tomography myelogram study revealed massive cerebrospinal fluid (CSF) leak spine.  Repeated blood patches using catheter targeted (C2) inject 15 mL autologous required totally alleviate her symptoms she failed conservative therapy. Determining optimal location approach administer patch can be challenge depending on CSF leak. Our demonstrates placement easily manipulated under fluoroscopic guidance is safe effective region caused prior injection.