Epidural blood patch following drainage of intracranial hemorrhage for a patient having spontaneous intracranial hypotension with subdural hematoma

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  • 硬膜下血腫を合併した特発性脳脊髄液減少症に対して穿頭血腫ドレナージ先行の硬膜外自家血パッチの同時手術を行った1例
  • 症例 硬膜下血腫を合併した特発性脳脊髄液減少症に対して穿頭血腫ドレナージ先行の硬膜外自家血パッチの同時手術を行った1例
  • ショウレイ コウマク カケッシュ オ ガッペイ シタ トクハツセイ ノウ セキズイエキ ゲンショウショウ ニ タイシテ セントウ ケッシュ ドレナージ センコウ ノ コウマク ガイ ジカ ケツ パッチ ノ ドウジ シュジュツ オ オコナッタ 1レイ

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A 51-year-old male undergoing conservative treatment for spontaneous intracranial hypotension developed disturbance of consciousness. Computed tomography (CT) of the head showed subdural hematoma, and a radionuclide cisternogram showed cerebrospinal fluid leakage from the lumbar. Neurological deterioration worsened, and an epidural blood patch was performed following drainage of the intracranial hemorrhage under general anesthesia. After this operation, his consciousness had restored and the headache was cured. A CT of the head after this operation revealed a high-density area similar to a subarachnoid hemorrhage appeared; however, it disappeared on the next day. Conservative treatment was continued until day 8 postoperatively. He was discharged on day 20 postoperatively and had no recurrence. A simultaneous operation, epidural blood patch following drainage of intracranial hemorrhage, was effective for a patient of spontaneous intracranial hypotension with subdural hematoma. However, it was necessary to examine the dose of autologous blood because of the expanse of epidural blood patch in this simultaneous case.

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