{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:33:05Z","timestamp":1764333185978,"version":"3.46.0"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>CT myelography is a definitive diagnostic tool for cerebrospinal fluid leakage. We report a case in which the site of a cerebrospinal fluid leak that had been difficult to identify on CT myelography was fortuitously localized owing to incidental injection of a contrast agent into the subdural space.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 37-year-old man developed headache and neck pain following a massage. He was diagnosed with intracranial hypotension, but the exact site of cerebrospinal fluid leakage could not be identified by CT myelography. An epidural blood patch was performed at the Th11\/12 level, during which a contrast agent was inadvertently injected into the subdural space, revealing cerebrospinal fluid leakage from the Th2\/3 level into the epidural space.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An unintentional subdural injection of contrast agent resulted in extensive distribution, facilitating the precise identification of the cerebrospinal fluid leakage site.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-025-00830-8","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:22:39Z","timestamp":1764332559000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unintentional injection of contrast agent into the subdural space during an epidural blood patch procedure identified the site of cerebrospinal fluid leak: a case report"],"prefix":"10.1186","volume":"11","author":[{"given":"Momoko","family":"Hattori","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7134-9942","authenticated-orcid":false,"given":"Hiroai","family":"Okutani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuu","family":"Kobata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Ishimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumiko","family":"Takao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobutaka","family":"Kariya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munetaka","family":"Hirose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"830_CR1","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1212\/01.wnl.0000144339.34733.e9","volume":"63","author":"S Berroir","year":"2004","unstructured":"Berroir S, Loisel B, Ducros A, Boukobza M, Tzourio C, Valade D, et al. Early epidural blood patch in spontaneous intracranial hypotension. Neurology. 2004;63:1950\u20131. https:\/\/doi.org\/10.1212\/01.wnl.0000144339.34733.e9.","journal-title":"Neurology"},{"key":"830_CR2","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1001\/jamaneurol.2020.4799","volume":"78","author":"L D\u2019Antona","year":"2021","unstructured":"D\u2019Antona L, Jaime Merchan MA, Vassiliou A, Watkins LD, Davagnanam I, Toma AK, et al. Clinical presentation, investigation findings, and treatment outcomes of spontaneous intracranial hypotension syndrome: a systematic review and meta-analysis. JAMA Neurol. 2021;78:329\u201337. https:\/\/doi.org\/10.1001\/jamaneurol.2020.4799.","journal-title":"JAMA Neurol"},{"key":"830_CR3","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/847085","volume":"2013","author":"K Sadacharam","year":"2013","unstructured":"Sadacharam K, Petersohn JD, Green MS. Inadvertent subdural injection during cervical transforaminal epidural steroid injection. Case Rep Anesthesiol. 2013;2013:847085. https:\/\/doi.org\/10.1155\/2013\/847085.","journal-title":"Case Rep Anesthesiol"},{"key":"830_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14050486","volume":"14","author":"SY Kang","year":"2024","unstructured":"Kang SY, Cho HS, Yi J, Jung SC, Kim HS, Jang IT, et al. Epidural, inadvertent subdural, and combined epidural-subdural anesthesia in lumbar spine surgery: a retrospective analysis. J Pers Med. 2024;14:486. https:\/\/doi.org\/10.3390\/jpm14050486.","journal-title":"J Pers Med"},{"key":"830_CR5","doi-asserted-by":"publisher","DOI":"10.5334\/jbsr.1877","volume":"104","author":"H Cebeci","year":"2020","unstructured":"Cebeci H, Bilgin C, Candan S, Demir AB, Hakyemez B. Spinal cerebrospinal fluid leakage in spontaneous intracranial hypotension: an intrathecal gadolinium enhanced MR-myelography study. J Belg Soc Radiol. 2020;104:6. https:\/\/doi.org\/10.5334\/jbsr.1877.","journal-title":"J Belg Soc Radiol"},{"issue":"2","key":"830_CR6","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.ijoa.2011.10.003","volume":"21","author":"LA Verduzco","year":"2012","unstructured":"Verduzco LA, Atlas SW, Riley ET. Subdural hematoma after an epidural blood patch. Int J Obstet Anesth. 2012;21(2):189\u201392. https:\/\/doi.org\/10.1016\/j.ijoa.2011.10.003.","journal-title":"Int J Obstet Anesth"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00830-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-025-00830-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00830-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:22:39Z","timestamp":1764332559000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-025-00830-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["830"],"URL":"https:\/\/doi.org\/10.1186\/s40981-025-00830-8","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"27 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 October 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We have obtained written consent from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"66"}}