1. Management of Spontaneous Intracranial Hypotension During Pregnancy: A Case Series
- Author
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Giuseppe Petrecca, Fabio Rubino, Michele Trimboli, Mirko Maria Ferrante, Francesco Allegrini, and Enrico Ferrante
- Subjects
Adult ,medicine.medical_treatment ,Intracranial Hypotension ,Bed rest ,03 medical and health sciences ,Sinus Thrombosis, Intracranial ,0302 clinical medicine ,Cerebrospinal fluid ,Pregnancy ,Medicine ,Humans ,030212 general & internal medicine ,Epidural blood patch ,Cerebrospinal fluid leak ,business.industry ,medicine.disease ,Pregnancy Complications ,Venous thrombosis ,Neurology ,Anesthesia ,Female ,Neurology (clinical) ,business ,Complication ,030217 neurology & neurosurgery ,Orthostatic headache ,Bed Rest - Abstract
Background Spontaneous intracranial hypotension (SIH) is a rare condition resulting from cerebrospinal fluid (CSF) volume depletion, nearly always from spontaneous CSF leaks. CSF pressure in SIH is usually normal; low CSF pressure is found in a substantial minority of patients. SIH is uncommonly described in pregnancy. Case series Five women with SIH during pregnancy have been conservatively treated adopting bed rest and overhydration. After prolonged conservative treatment, only 1 patient showed complete symptoms resolution. A rare SIH complication as cerebral venous thrombosis has been reported in 1 case. All 4 remaining patients had lumbar epidural blood patch (EBP) with symptoms disappearance. Conclusions EBP might be proposed to SIH patients also during pregnancy and after a brief period (~10 days) of ineffective conservative treatment, because it could allow faster symptoms improvement and complete recovery. Furthermore, EBP would avoid prolonged bed rest with the risk of SIH severe complications.
- Published
- 2020