Effect of blind versus fluoroscopic guidance epidural blood patch in patients with intracranial hypotension

•Epidural blood patch (EBP) is effective treatment for intracranial hypotension (IH).•EBP can be performed using the blind technique in the lateral position.•EBP can also be performed under fluoroscopic guidance in the prone position.•Blind and fluoroscopic-guidance EBP were effective in patients wi...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2024-05, Vol.123, p.118-122
Main Authors: Lee, Jiyoun, Kang, Hyunjong, Kim, Seekyo, Jung, Young-hoon, Lee, Dowon, Kim, Eunsoo, Baik, Jiseok
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Patch, Epidural - methods
Epidural blood patch
Female
Fluoroscopy - methods
Humans
Iatrogenic intracranial hypotension
Intracranial hypotension
Intracranial Hypotension - diagnostic imaging
Intracranial Hypotension - therapy
Male
Middle Aged
Patient Positioning - methods
Postdural puncture headache
Retrospective Studies
Spontaneous intracranial hypotension
Treatment Outcome
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Summary:•Epidural blood patch (EBP) is effective treatment for intracranial hypotension (IH).•EBP can be performed using the blind technique in the lateral position.•EBP can also be performed under fluoroscopic guidance in the prone position.•Blind and fluoroscopic-guidance EBP were effective in patients with iatrogenic IH.•In spontaneous IH, fluoroscopic guidance in the prone position was superior. Epidural blood patch (EBP)—the most effective treatment for intracranial hypotension (IH)—can be performed using the blind technique in the lateral position or under fluoroscopic guidance in the prone position. This study aimed to compare the effectiveness of EBP in patients with spontaneous intracranial hypotension (sIH) and iatrogenic intracranial hypotension (iIH) when performed with the blind technique in the lateral decubitus position or fluoroscopic guidance in the prone position. We reviewed IH patients who underwent EBP between January 2015 and September 2019 in a single hospital and divided them into two groups according to the type of IH. Of the 84 included patients, 36 had sIH and 48 had iIH. We compared the effectiveness of EBP using the two methods in each group. There was no significant difference in the effect of EBP between the patients with iIH (p > 0.05). For patients with sIH, fluoroscopic guidance in the prone position technique showed better improvement than the blind technique in the lateral decubitus position (p 
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2024.03.029