Research Identifies Which Patients Benefit from Additional Testing to Find CSF Leaks
Research to be presented at the 16th Annual Pain Medicine Meeting
Cerebrospinal fluid (CSF) hypovolemia (too little CSF) refers to a clinical condition where a spontaneous leak from the spine causes disabling positional headaches that worsen while upright and improve by lying down. In addition to headache, hypovolemia can lead to a reversible dementia syndrome. Although often unrecognized, CSF hypovolemia is diagnosed with brain MRI and treated with epidural blood patches, a procedure where blood is removed from the patient and then injected in the spinal epidural space, which is the spinal compartment immediately superficial to the cerebrospinal fluid space. This procedure is done in an attempt to seal the leak. Blood patches delivered directly to the site of CSF leak are more effective than non-site directed epidural blood patches delivered randomly and likely distant from the site of leak. However, diagnostic testing for discovering the site of leaks can be invasive and costly. Researchers at Mayo Clinic sought to determine which CSF hypovolemia patients are better served by more intensive diagnostic testing upfront to find the specific leak site versus deferring testing and performing non-site directed epidural blood patches.
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