Objective: To report the authors' own experience in the treatment of spontaneous intracranial hypotension (SIH) with targeted epidural blood patch after locating the CSF leaks with CT myelography (CTM) and to discuss the mechanism and value of this method.
Methods: Six patients with SIH (3 males and 3 females aged 33-66 years) were included. All patients met the diagnostic criteria of 2nd edition of International Classification of Headache Disorders (2004). CT myelography revealed the CSF leak sites in all 6 patients. Autologous blood mixed with Omnipaque (300 mg/ml) was injected after selective puncture at the leak site indicated by CTM.
Results: All patients responded well to the treatment and achieved a complete resolution of symptoms. Nerve root irritation occurred in 2 patients. Three patients suffered from a temporary back pain.
Conclusion: With the location of leak sites by CTM, targeted epidural blood patch is an effective way to treat spontaneous intracranial hypotension.