JA clinical reports · 2025
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.
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Hattori Momoko, Okutani Hiroai, Kobata Mayuu, Ishimoto Daisuke, Takao Yumiko, Kariya Nobutaka, Hirose Munetaka
Аннотация
BACKGROUND: 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.
CASE PRESENTATION: 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.
CONCLUSIONS: An unintentional subdural injection of contrast agent resulted in extensive distribution, facilitating the precise identification of the cerebrospinal fluid leakage site.
CASE PRESENTATION: 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.
CONCLUSIONS: An unintentional subdural injection of contrast agent resulted in extensive distribution, facilitating the precise identification of the cerebrospinal fluid leakage site.