AJDRAJNR - American Journal of Neuroradiology

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Case Report
SPINE

Epidural Blood Patch at C2: Diagnosis and Treatment of Spontaneous Intracranial Hypotension

Ansaar Raia,b, Charles Rosenb, Jeffrey Carpentera and Vincent Mieleb

a Department of Radiology, West Virginia University, Morgantown, WV
b Department of Neurosurgery, West Virginia University, Morgantown, WV

Address correspondence to Ansaar Rai, MD, Department of Radiology, West Virginia University, PO Box 9235, Morgantown, WV 26506-9235

Summary: Spontaneous intracranial hypotension in a 37-year-old man with intractable headaches was diagnosed on MR imaging. A generous CSF leak was identified at C2 on CT myelography. Successful treatment was performed with CT-guided blood patch at the leakage site after the patient had failed 2 lumbar blood patches. Imaging-guided precise placement of the blood patch is safe and recommended when a lumbar blood patch away from the leakage site could be ineffective.