Spontaneous Intracranial Hypotension: A Case Report of Non-targeted Epidural Blood Patch Treatment

The rise in the incidence rate of spontaneous intracranial hypotension (SIH) has increased the burden on physicians to accurately diagnose and treat patients presenting with SIH. However, conclusive evidence on the efficacy and risks associated with targeted epidural blood patches (EBPs) versus nontargeted ones does not exist. Herein, we describe two patients diagnosed with SIH who were treated with lumbar EBPs rather than with targeted EBPs at Vanderbilt University Medical Center. However, both patients were instructed to stay supine for 24 hours after the procedure. Both patients reported drastic improvement of symptoms within two days of the procedure. Furthermore, neither of the patients had any complications associated with the treatment. Based on this evidence, lumbar EBPs followed by rest in the supine position could be an effective and safe solution to SIH patients with CSF leaks in the cervical or thoracic regions of the spine. However, more detailed studies need to be performed for conclusive evidence on this topic.