{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:29:58Z","timestamp":1784543398432,"version":"3.55.0"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Recent evidence has indicated that the efficacy of the epidural blood patch (EBP) in the treatment of spontaneous CSF hypovolemia (SCH) is still limited. Therefore, further improvement of the EBP technique is an important clinical challenge. The authors describe a series of cases of SCH treated with fluoroscopically guided placement of an EBP and followed up with subsequent spinal CT scans.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Thirteen patients with SCH that was proven on CT myelography studies underwent epidural puncture under fluoroscopic guidance and received an injection of a mixture of contrast medium and autologous blood. Contrast medium was injected to cover the area of CSF leakage during EBP guided by fluoroscopy, and the spread of the blood was subsequently evaluated using spinal CT scanning. If the amount of blood injected was insufficient to cover the leakage area, a second EBP was performed at a later date.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>At the first EBP procedure, a mixture with a mean volume of 9.4 ml (range 3\u201320 ml) was injected, and subsequent spinal CT scans revealed contrast enhancement in the desired epidural space in 12 of 13 patients. In 2 patients, a second EBP was required because of insufficient coverage of the leakage area or delayed recurrence of headache. In all patients, a complete recovery from orthostatic headache was obtained after the last EBP.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The results indicated that fluoroscopically guided EBP and subsequent spinal CT scans may provide a highly effective therapy in patients with SCH proven on CT myelography studies.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.1.jns101326","type":"journal-article","created":{"date-parts":[[2011,2,18]],"date-time":"2011-02-18T15:22:03Z","timestamp":1298042523000},"page":"1731-1735","source":"Crossref","is-referenced-by-count":20,"title":["Fluoroscopically guided epidural blood patch with subsequent spinal CT scans in the treatment of spontaneous cerebrospinal fluid hypovolemia"],"prefix":"10.3171","volume":"114","author":[{"given":"Keisuke","family":"Watanabe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Hashizume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Sasaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Furuya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101326","series-title":"Neurology","first-page":"1950","article-title":"Early epidural blood patch in spontaneous 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puncture: review of the epidural blood patch","volume":"81","author":"McGruder","year":"1988"},{"key":"b15-jns101326","series-title":"Neurol Clin","first-page":"55","article-title":"Low cerebrospinal fluid pressure syndromes","volume":"22","author":"Mokri","year":"2004"},{"key":"b16-jns101326","series-title":"Mayo Clin Proc","first-page":"1113","article-title":"Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia\u2014evolution of a concept","volume":"74","author":"Mokri","year":"1999"},{"key":"b17-jns101326","series-title":"Eur J Neurol","first-page":"1128","article-title":"Spontaneous cerebrospinal fluid hypovolaemia: a therapeutic dilemma?","volume":"13","author":"Nowak","year":"2006"},{"key":"b18-jns101326","series-title":"JAMA","first-page":"2286","article-title":"Spontaneous spinal cerebrospinal fluid leaks and intracranial 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