New Publication

Expanding Epidural Patching Techniques for Spinal CSF Leak

Expanding Epidural Patching Techniques for Spinal CSF Leak

CT-fluoroscopy-Guided Ventral CSF Leak Patching Shared with permission from Timothy Amhrein, MD and Duke University Medical Center Several centers in the USA and elsewhere that see larger numbers of patients with spinal CSF (cerebrospinal fluid) leaks are continually...

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Epidural Patching with Blood + Fibrin Sealant

Epidural Patching with Blood + Fibrin Sealant

Physicians at Mayo Rochester have reported on a small series of 8 patients with refractory headache after epidural blood patch. They were then treated with a combination of blood and fibrin glue for epidural patching. Four of eight patients had improved pain scores at...

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Atypical and serious cases of intracranial hypotension

Atypical and serious cases of intracranial hypotension

This recent paper highlights that the clinical presentation of spontaneous intracranial hypotension secondary to spinal cerebrospinal fluid leak may include serious patterns considered atypical. The authors compared the clinical and imaging findings of 8 atypical...

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Digital Subtraction Myelography

Digital Subtraction Myelography

A variety of spinal imaging techniques are currently employed in patients with spontaneous intracranial hypotension to localize spinal CSF leaks. Digital subtraction myelography (DSM) is being used increasingly, most often to visualize the origin of rapid leaks. A...

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Imaging findings in spinal CSF leaks can be misleading

Imaging findings in spinal CSF leaks can be misleading

The initial treatment of spontaneous spinal cerebrospinal fluid (CSF) leaks does not require localization of the CSF leak with spinal imaging, since one or more non-directed epidural blood patches are often effective. In those situations where conservative measures or...

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Changing the Needle for Lumbar Punctures

by Connie Deline, MD This new prospective study deserves a spotlight here. Lumbar puncture is the most common cause of a spinal CSF leak and is known as a post-dural puncture headache (PDPH). Because smaller needles and non-cutting needles have been shown repeatedly...

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