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Papers of the Week

2020 05

World Neurosurg


Epidural Blood Patch as a diagnostic and therapeutic intervention in Spontaneous Intracranial Hypotension – a novel approach to management.


Davies MJ, Davies MA, Sharpe R, Cordato D, Schwartz R
World Neurosurg. 2020 05; 137:e242-e250.
PMID: 32004736.


Spontaneous Intracranial Hypotension (SIH) remains a diagnostic and therapeutic challenge. Non-specific clinical features and a reluctance to treat without confirmatory imaging evidence undermine management. Investigations are often insensitive, expensive with many patients continuing to an Epidural Blood Patch (EBP) despite negative results. Current diagnostic standards are based upon a literature base skewed towards difficult to treat cases at specialty centers. This study aims to develop a robust diagnostic and treatment algorithm in real-life clinical practice by 1) investigating the prognostic utility of symptoms of SIH and results of associated investigation from which a scoring system is derived and 2) analysing the role of EBP as a diagnostic and treatment tool.