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Titolo:
Epidemiology and outcome of postural headache management in spontaneous intracranial hypotension
Autore:
Diaz, JH;
Indirizzi:
Louisiana State Univ, Sch Med, Dept Publ Hlth, New Orleans, LA 70112 USA Louisiana State Univ New Orleans LA USA 70112 , New Orleans, LA 70112 USA Louisiana State Univ, Sch Med, Dept Prevent Med, New Orleans, LA 70112 USALouisiana State Univ New Orleans LA USA 70112 , New Orleans, LA 70112 USA Louisiana State Univ, Sch Med, Dept Anesthesiol, New Orleans, LA 70112 USALouisiana State Univ New Orleans LA USA 70112 , New Orleans, LA 70112 USA
Titolo Testata:
REGIONAL ANESTHESIA AND PAIN MEDICINE
fascicolo: 6, volume: 26, anno: 2001,
pagine: 582 - 587
SICI:
1098-7339(200111/12)26:6<582:EAOOPH>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CSF PRESSURE HEADACHE; EPIDURAL BLOOD PATCH; HEARING-LOSS; ANESTHESIA; LUMBAR; LEAK;
Keywords:
pain : head; headache : postural, postdural puncture; spontaneous intracranial hypotension : epidural blood patch;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Diaz, JH Louisiana State Univ, Sch Med, Dept Publ Hlth, 1600 Canal St,Suite 800, New Orleans, LA 70112 USA Louisiana State Univ 1600 Canal St,Suite 800 New Orleans LA USA 70112
Citazione:
J.H. Diaz, "Epidemiology and outcome of postural headache management in spontaneous intracranial hypotension", REG ANES PA, 26(6), 2001, pp. 582-587

Abstract

Background and objectives: Spontaneous intracranial hypotension is a postural headache syndrome unrelated to dural puncture. Due to the apparent failure of epidural blood patch to relieve headache in spontaneous intracranialhypotension, we investigated the epidemiologic features and treatment outcomes of this condition. Methods: The clinical findings and management of 22 cases (21 published + 1 reported) of spontaneous intracranial hypotension were analyzed retrospectively. The study population was stratified by age and sex; continuous variables were compared for differences by t-tests; categorical variables were compared by Fisher exact tests. Significant differences were identified by P values of .05 or less. Results: The mean age of the study population was 43 +/- 16 years, with a female:male ratio of 3.4:1.0. Females with spontaneous intracranial hypotension were younger (P =.050) than males, Men presented with tinnitus (P =.021) and visual field defects (P =.009) more often than women. Meningeal enhancement on contrast magnetic resonance imaging was the most consistent radiographic finding. Radionuclide cisternography showed thoracolumbar dural leaks in 7 of 9 patients. Cerebrospinal fluid opening pressure was low in allpatients (33.13 +/- 31.02 mm H2O). Epidural blood patch was performed in 8patients, repeated in 3 patients, failed in 3 patients, and offered only transient improvement in 5 patients. Conclusions: Spontaneous intracranial hypotension was more common in womenthan men, was not uniformly responsive to epidural blood patch, and had significant comorbidities. The management of postural headache in spontaneousintracranial hypotension by other techniques to restore cerebrospinal fluid dynamics and prevent its leakage should be investigated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/04/20 alle ore 10:51:07