Clinical observation on the treatment of spontaneous intracranial hypotension with blind epidural autologous blood patch

Objective To discuss therapeutic mechanism and application value of blind epidural autologous blood patch in the treatment of spontaneous intracranial hypotension(SIH). Methods All patients met the diagnostic criteria of 2nd edition of international classification of headache disorders(2004).The blind epidural autologous venous blood patch was performed in 6 patients with SIH (2 males and 4 females,aged 44-70 years).The puncture and external epidural catheter was performed at intervertebral disc space between L₁ and L₂.The Fresh autologous venous blood was transferred into epidural space through the catheter.All the patients were followed up to observe the therapeutic efficacy. Results All patients responded well to the treatment and achieved a complete resolution of symptoms.Among the 6 patients,4 cases recovered by the first procedure,1 case recovered after the second transfusion,the other one received additional epidural autologous venous blood patch treatment between L₂ and L₃ one time,and L₁ and L₂ two times.The 3-9 months follow up showed that there was no recurrence after the operation. Conclusion The blind epidural blood patch is an effective,safe and easy way to treat spontaneous intracranial hypotension,not need the leakage point location by imaging.