{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:14:52Z","timestamp":1760242492990,"version":"build-2065373602"},"reference-count":12,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100020867","name":"The Montreal Children\u2019s Hospital Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020867","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Louis and Alan Edwards Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,3,22]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There is increasing evidence for the use of multilevel epidural catheter-guided blood patches to treat spontaneous cerebrospinal fluid leaks in adults. Yet, there are scarce data for their use in children. Furthermore, higher level epidural blood patches are uncommon in both adult and pediatric populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>An adolescent boy with multilevel cerebrospinal fluid leaks associated with status migrainosus failed conservative pain management treatment. As he remained severely symptomatic, epidural blood patches were required to mitigate his symptoms. Given his multilevel leaks, a catheter-guided blood patch approach was used to treat multiple cervicothoracic and thoracolumbar leaks. After three separate uneventful blood patch procedures, the patient was free of symptoms. Other than some rebound intracranial hypertension, the patient maintained full neurological capacity without further complications. Following the resolution of treatment, he has not sought help for pain since his last blood patch over a year ago.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Multilevel catheter-guided blood patches have the potential to be administered to higher level spinal regions to the pediatric population suffering from multiple spontaneous cerebrospinal fluid leaks.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2022-103487","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T12:16:09Z","timestamp":1648728969000},"page":"430-433","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Catheter-guided multilevel epidural blood patches in an adolescent boy"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8632-1555","authenticated-orcid":false,"given":"Laurel","family":"Walfish","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sultan","family":"Alobaikan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, King Abdulaziz Medical City, Riyadh, Al Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubin","family":"Lahijanian","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Saint-Martin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Montreal Children's Hospital, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria delPilar","family":"Cortes Nino","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo Mauricio","family":"Ingelmo","sequence":"additional","affiliation":[{"name":"Edward\u2019s Family Interdisciplinary Center for Complex Pain, Montreal Children's Hospital, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"2025101111451480000_47.7.430.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2009.03514.x"},{"key":"2025101111451480000_47.7.430.2","doi-asserted-by":"crossref","first-page":"343","DOI":"10.36076\/ppj.2015\/18\/343","article-title":"Thoracic epidural blood patches in the treatment of spontaneous intracranial hypotension: a retrospective case series","volume":"18","author":"Feltracco","year":"2015","journal-title":"Pain Physician"},{"key":"2025101111451480000_47.7.430.3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s13760-019-01166-8","article-title":"Spontaneous intracranial hypotension: review and expert opinion","volume":"120","author":"Ferrante","year":"2020","journal-title":"Acta Neurol Belg"},{"key":"2025101111451480000_47.7.430.4","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31822e5665"},{"key":"2025101111451480000_47.7.430.5","doi-asserted-by":"publisher","DOI":"10.3171\/2012.1.JNS111568"},{"key":"2025101111451480000_47.7.430.6","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1002\/ana.25837","article-title":"Spontaneous multilevel cerebrospinal fluid leak in Marfan syndrome","volume":"88","author":"Mirchi","year":"2020","journal-title":"Ann Neurol"},{"key":"2025101111451480000_47.7.430.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.19.2286"},{"key":"2025101111451480000_47.7.430.8","doi-asserted-by":"publisher","DOI":"10.1177\/0883073810389042"},{"key":"2025101111451480000_47.7.430.9","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3841"},{"key":"2025101111451480000_47.7.430.10","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1111\/pme.12793","article-title":"Cervical epidural blood patch--A literature review","volume":"16","author":"Kapoor","year":"2015","journal-title":"Pain Med"},{"key":"2025101111451480000_47.7.430.11","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jpeds.2013.01.055","article-title":"Spontaneous intracranial hypotension in childhood and adolescence","volume":"163","author":"Schievink","year":"2013","journal-title":"J Pediatr"},{"key":"2025101111451480000_47.7.430.12","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3945"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2022-103487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:45:24Z","timestamp":1760208324000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2022-103487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,31]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,5,24]]},"published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1136\/rapm-2022-103487"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2022-103487","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"type":"print","value":"1098-7339"},{"type":"electronic","value":"1532-8651"}],"subject":[],"published":{"date-parts":[[2022,3,31]]}}}