{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T08:04:43Z","timestamp":1789286683152,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify predictors of epidural blood patch (EBP) success in patients with intracranial hypotension syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The epidural blood patch remains the gold standard treatment for intracranial hypotension syndrome, yet its effectiveness varies, and predictors of sustained success remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a single\u2010center retrospective cohort study. We analyzed 139 epidural blood patches performed for non\u2010obstetric intracranial hypotension syndrome between April 2015 and July 2025. Demographic, clinical, biological, radiological, and procedural data were collected. Complete symptom resolution or highly significant improvement at 1 month was defined as treatment success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 93 patients, 1\u2010month complete success was achieved after 31% of procedures (43\/139). Early improvement within 48\u2009h was associated with higher odds of 1\u2010month EBP success (adjusted odds ratio [aOR]\u2009=\u20099.70, 95% confidence interval [CI]: 3.66\u201328.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as was the occurrence of rebound headache (aOR\u2009=\u20095.34, 95% CI: 1.27\u201326.44;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). Conversely, symptom exacerbation during the Valsalva maneuver was associated with lower odds of 1\u2010month EBP success (aOR\u2009=\u20090.30, 95% CI: 0.10\u20130.81;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020). Lower baseline platelet and fibrinogen levels and osteophytic leaks were negatively associated with early effectiveness but not with 1\u2010month outcome. Targeted epidural blood patches and shorter delay from symptom onset to procedure were associated with higher success rates in univariate analysis, though not independently. Model performance was robust with an area under the curve (AUC) of 0.88 (95% CI: 0.80\u20130.90). No infectious complications were observed; rebound headaches and transient back pain were the most common secondary events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early clinical improvement and rebound headache are strong positive predictors of durable epidural blood patch effectiveness in intracranial hypotension syndrome, whereas Valsalva\u2010related symptom worsening indicates a higher risk of failure. Radiological severity did not predict outcomes in our study. These easily identifiable clinical factors can assist in individualized management and reduce unnecessary repeat procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70191","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:13:17Z","timestamp":1784182397000},"page":"1847-1858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive factors of epidural blood patch success in intracranial hypotension syndrome"],"prefix":"10.1111","volume":"66","author":[{"given":"Anna","family":"Le Moal\u2010Baczynski","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Aix Marseille University, AP\u2010HM, University Hospital Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Castelli","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Aix Marseille University, AP\u2010HM, University Hospital Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Doat\u2010Sarfati","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Sorbonne Universit\u00e9, AP\u2010HP, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital  Paris France"},{"name":"Paris Brain Institute, Laboratoire GenoVasc, INSERM U1127  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6898-2392","authenticated-orcid":false,"given":"Sylvain","family":"Redon","sequence":"additional","affiliation":[{"name":"Department of Evaluation and Treatment of Pain Aix Marseille University, AP\u2010HM, University Hospital Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Donnet","sequence":"additional","affiliation":[{"name":"Department of Evaluation and Treatment of Pain Aix Marseille University, AP\u2010HM, University Hospital Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bruder","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Aix Marseille University, AP\u2010HM, University Hospital Conception  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Antonini","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Aix Marseille University, AP\u2010HM, North University Hospital  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Henri","sequence":"additional","affiliation":[{"name":"Department of Evaluation and Treatment of Pain Aix Marseille University, AP\u2010HM, University Hospital Timone  Marseille 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