Life (Feb 2024)

Spontaneous Intracranial Hypotension and Subdural Hematomas Treatment Management Using MMA Embolization and Target Blood Patch: A Case Report

  • Luigi Cirillo,
  • Francesca Verna,
  • Ciro Princiotta,
  • Massimo Dall’Olio,
  • Arianna Rustici,
  • Carlo Bortolotti,
  • Filippo Badaloni,
  • Davide Mascarella,
  • Pietro Cortelli,
  • Sabina Cevoli

DOI
https://doi.org/10.3390/life14020250
Journal volume & issue
Vol. 14, no. 2
p. 250

Abstract

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We report a patient suffering from spontaneous intracranial hypotension (SIH) who, following a non-selective lumbar blood patch, returned to his healthcare provider with severe symptoms of neurological deficits. It was subsequently discovered that the aforementioned deficits were due to a bilateral subdural hematoma, and an emergency surgical drainage of the hematoma has been performed. However, the hematoma reformed and potential cerebrospinal fluid leakage was consequently investigated through myelography. Following the diagnostic finding of a venous diverticulum, a selective blood patch was executed in the affected area, and in order to stabilize the hematoma, an embolization of the middle meningeal arteries was performed. The combination of such operations allowed for the resorption of the hematoma and the improvement of neurological symptoms.

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