Management of post blood patch severe rebound intracranial hypertension by the usage of an external ventricular drain

被引：2

作者：

Maresca, Leonardo ^{[1
]}

Fragale, Maria ^{[1
,2
]}

Petrella, Giacomo ^{[1
]}

Boeris, Davide ^{[1
]}

机构：

[1] ASST Grande Osped Metropolitano Niguarda, Neurosurg, Milan, Lombardia, Italy

[2] Univ Roma La Sapienza, Neurosurg, Rome, Lazio, Italy

来源：

BMJ CASE REPORTS | 2024年 / 17卷 / 03期

关键词：

Neurosurgery; Neurology; Clinical neurophysiology; Coma and raised intracranial pressure; Headache (including migraines); DIAGNOSTIC-CRITERIA; HEADACHE;

D O I：

10.1136/bcr-2023-257743

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Spontaneous intracranial hypotension (SIH) is a condition characterised by postural headaches due to low cerebrospinal fluid (CSF) pressure, often stemming from CSF leakage. Diagnosis poses a significant challenge, and the therapeutic approach encompasses both conservative measures and operative interventions, such as the epidural blood patch (EBP). However, EBP carries the potential risk of inducing rebound intracranial hypertension (RIH), subsequently leading to high-pressure headaches. We present a case wherein RIH following EBP was effectively managed through the implementation of an external ventricular drain (EVD) aimed at reducing CSF pressure. The patient improved significantly, underscoring the potential utility, if not necessity, of EVD in carefully selected cases, highlighting the imperative for further research to enhance the management of SIH and optimise EBP-related complications.

引用

页数：6