{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:24:35Z","timestamp":1762082675999,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to identify predictors for the recurrence of spontaneous intracranial hypotension (SIH) after epidural blood patch (EBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidural blood patch is the main treatment option for SIH; however, the characteristics of patients who experience relapse after successful EBP treatment for SIH remain understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this exploratory, retrospective, case\u2013control study, we included 19 patients with SIH recurrence after EBP and 36 age\u2010 and sex\u2010matched patients without recurrence from a single tertiary medical institution. We analyzed clinical characteristics, neuroimaging findings, and volume changes in intracranial structures after EBP treatment. Machine learning methods were utilized to predict the recurrence of SIH after EBP treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no significant differences in clinical features between the recurrence and no\u2010recurrence groups. Among brain magnetic resonance imaging signs, diffuse pachymeningeal enhancement and cerebral venous dilatation were more prominent in the recurrence group than no\u2010recurrence group after EBP (14\/19 [73%] vs. eight of 36 [22%] patients,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; 11\/19 [57%] vs. seven of 36 [19%] patients,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010, respectively). The midbrain\u2013pons angle decreased in the recurrence group compared to the no\u2010recurrence group after EBP, at a mean (standard deviation [SD]) of \u201312.0 [16.7] vs. +1.8[18.3]\u00b0 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). In volumetric analysis, volume changes after EBP were smaller in the recurrence group than in the no\u2010recurrence group in intracranial cerebrospinal fluid (mean [SD] \u221211.6\u2009[15.3] vs. +4.8\u2009[17.1] mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and ventricles (mean [SD] +1.0\u2009[2.0] vs. +2.0\u2009[2.5] mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Notably, the random forest classifier indicated that the model constructed with brain volumetry was more accurate in discriminating SIH recurrence (area under the curve\u2009=\u20090.80 vs. 0.52).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study suggests that volumetric analysis of intracranial structures may aid in predicting recurrence after EBP treatment in patients with SIH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14703","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T09:05:33Z","timestamp":1713431133000},"page":"380-389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors to predict recurrence after epidural blood patch in patients with spontaneous intracranial hypotension"],"prefix":"10.1111","volume":"64","author":[{"given":"Seung Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology Seoul Medical Center  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jooyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Applied Statistics Chung\u2010Ang University  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da\u2010woon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Applied Statistics Chung\u2010Ang University  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology Seoul Medical Center  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Jae","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Neurology Seoul Medical Center  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moon Gwan","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology Seoul Medical Center  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sungyang","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong Hyun","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research institute of Radiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South\u00a0Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun J.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul 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