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경막외강조영술은 자발성 두개내 저압성 두통의 뇌척수액 누출부위를 찾는데 유용한 방법이다
송선옥,조영우,김세연,정기승,서영호,장주현 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.1
An Epidurogram is an Alternative Diagnostic Tool for Discovering the Site of CSF Leakage in Spontaneous Intracranial Hypotension Sun Ok Song, M.D., Sae Yeun Kim, M.D., Young Woo Cho, M.D. Gi Seung Jung, M.D., Yeung Ho Suh, M.D., and Ju Hyun Chang, M.D. Department of Anesthesiology, College of Medicine, Yeungnam University, Daegu, Korea Spontaneous intracranial hypotension (SIH) is a rare disease with a symptom of a postural headache, which is aggravated by the erect position and relieved by the supine position. This persistent headache is dramatically improved with an epidural blood patch. C6-7 is the most common site of leakage of cerebrospinal fluid (CSF) from the subarachnoid space in SIH. The diagnosis of SIH is based on a typical history. It is supported by low CSF pressure in a lumbar puncture and diffuse dural enhancement on a brain MRI, and confirmed by a CSF leakage site on a radioisotope cistemography or on a myelography. However, we had two patients of SIH whose CSF leakage site was not found on cisternography. We tried an epidurogram just before an injection of autologous blood for an epidural blood patch, and found specific finding on the epidurogam suggesting the CSF leakage site, such as a filling defect on C6-7 during dye injection, and delayed washout of dye around the filling defect on the epidurogram performed at C7-T1/C6-7. Therefore, we suggest that an epidurogram is occasionally a useful diagnostic tool when looking for the site of CSF leakage in SIH. (Korean J Anesthesiol 2001;41: 114~119)