Epidural Blood Patch Using a Racz Catheter for Spontaneous Intracranial Hypotension With Unclear Leak Points

Megumi Kanao-Kanda; Satoru Hiroshima; Izumi Sato; Ririko Nagabuchi; Hirotsugu Kanda

doi:10.7759/cureus.23559

Epidural Blood Patch Using a Racz Catheter for Spontaneous Intracranial Hypotension With Unclear Leak Points

Cureus. 2022 Mar 28;14(3):e23559. doi: 10.7759/cureus.23559. eCollection 2022 Mar.

Authors

Megumi Kanao-Kanda¹, Satoru Hiroshima², Izumi Sato¹, Ririko Nagabuchi¹, Hirotsugu Kanda¹

Affiliations

¹ Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, JPN.
² Neurosurgery, Asahikawa Medical University, Asahikawa, JPN.

Abstract

Using a Racz catheter (Brevi-XL™, Epimed Inc., NY, USA) to insert an epidural blood patch (EBP) may be an effective method of reaching the target epidural space in the cervical region. We would like to present a case, wherein a targeted EBP via Racz catheter was used in the management of spontaneous intracranial hypotension. When the leak point is clear via imaging, EBP should be performed exactly at that point. However, if the leak point is unclear, with only a contrast agent pool detected via imaging, EBP should be performed to mask the entire region of the pool. In both cases, EBP via Racz catheter is a convenient and effective method for the management of spontaneous intracranial hypotension. Further cases may be needed to verify our results.

Keywords: cerebrospinal fluid leakage; epidural blood patch; orthostatic headache; racz catheter; spontaneous intracranial hypotension.

Publication types

Case Reports