Extensive epidural fluid collections: does it influence the outcome?

Coleções exuberantes de líquor epidural: influência na resposta ao tratamento?

IMAGES IN NEUROLOGY

Extensive epidural fluid collections: does it influence the outcome?

Coleções exuberantes de líquor epidural: influência na resposta ao tratamento?

Sara França^I; Ana Teresa Carvalho^I; Joana Guimarães^I; Rita Figueiredo^II; Carina Reis^II; Maria Armanda Gomes^III

^ICentro Hospitalar de São João, Porto – Portugal: Neurology Department

^IICentro Hospitalar de São João, Porto – Portugal: Neuroradiology Department

^IIICentro Hospitalar de São João, Porto – Portugal: Anesthesiology Department

^{Correspondence}

A 32-year-old woman presented with a three-day history of orthostatic headache. Brain CT and MRI were normal. Hole-spine MR mielography and conventional Spine MRI disclosed exuberant enlargement of posterior epidural space and images suggestive of cervical CSF leak (Fig 1). CT myelography confirmed CSF leak. It was performed conservative treatment without symptom relief. Clinical improvement was only evident after third epidural blood patch. Five months later, she remained asymptomatic despite mantaining exuberant collections, not supporting a correlation between imagiological and clinical improvement (Fig 2). Another question that remains to be solved is whether the extent of the collections of CSF influences the outcome¹.

Received 14 December 2011

Accepted 28 December 2011

Conflict of interest: There is no conflict of interest to declare.

• 1. Inamasu J, Nakatsukasa M. Blood patch for spontaneous intracranial hypotension caused by cerebrospinal fluid leak at C1-2. Clin Neurol Neurosurg 2007;109:716-719.

Publication Dates

• Publication in this collection
  15 May 2012
• Date of issue
  May 2012