versão impressa ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.70 no.5 São Paulo maio 2012
IMAGES IN NEUROLOGY
Coleções exuberantes de líquor epidural: influência na resposta ao tratamento?
Sara FrançaI; Ana Teresa CarvalhoI; Joana GuimarãesI; Rita FigueiredoII; Carina ReisII; Maria Armanda GomesIII
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
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.
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. [ Links ]
Alameda Professor Hernâni Monteiro 4202/451
Porto - Portugal
Received 14 December 2011
Accepted 28 December 2011
Conflict of interest: There is no conflict of interest to declare.