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Tytuł:
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Recurrent Spontaneous Cerebrospinal Fluid Leaks at Multiple Levels.
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Autorzy:
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Bhoi SK; Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Naik S; Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Gupta D; Department of Anaesthesia, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Pradhan PK; Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Kalita J; Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Misra UK; Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
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Źródło:
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Neurology India [Neurol India] 2021 Nov-Dec; Vol. 69 (6), pp. 1828-1830.
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Typ publikacji:
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Case Reports
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Język:
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English
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Imprint Name(s):
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Publication: Mumbai : Medknow Publications
Original Publication: Bombay : Neurological Society of India
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MeSH Terms:
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Cerebrospinal Fluid Leak*/diagnostic imaging
Cerebrospinal Fluid Leak*/etiology
Intracranial Hypotension*/complications
Intracranial Hypotension*/diagnostic imaging
Blood Patch, Epidural ; Humans ; Myelography ; Tomography, X-Ray Computed
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Contributed Indexing:
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Keywords: CSF leak; CT myelography; Craniospinal hypotension; epidural blood patch; nuclear scintigraphy
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Entry Date(s):
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Date Created: 20220104 Date Completed: 20220105 Latest Revision: 20220105
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Update Code:
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20240104
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DOI:
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10.4103/0028-3886.333501
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PMID:
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34979700
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Intracranial hypotension due to multiple spinal epidural cerebrospinal fluid (CSF) leak is rare and has multiple etiologies. These patients require epidural blood patches (EBP). We report a patient with recurrent paraplegia due to intracranial hypotension following recurrent epidural CSF leak. Cerebrospinal fluid leak was noted at D1, D10, D11, and L2 levels. Autologous epidural blood patch (EBP) at lower thoracic (3 ml) and lumbar region (4 ml) was performed. The patient developed paraplegia with sensory level at D2 for which 3 ml of EBP was done at D1 level after two months. Following EBP, the patient developed quadriplegia and root pain, which recovered in one month. The patient was free of symptoms for 18 months. Spinal epidural CSF leak should be suspected in patients with features of low pressure headache and recurrent paraplegia at multiple levels. Nuclear scintigraphy and CT myelography help in localizing the site of leak.
Competing Interests: None
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