Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned
Joint Authors
Hillegass, Michael G.
Luebbert, Samuel F.
McClenahan, Maureen F.
Source
Case Reports in Anesthesiology
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-07-03
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
We report a case in which a 34-year-old female with refractory intracranial hypotension headaches due to a spontaneous dural tear was ultimately treated with CT-guided transforaminal epidural placement of a synthetic absorbable sealant (DuraSeal®).
The procedure successfully resolved her headaches; however she subsequently developed thoracic neuralgia presumably due to mass effect of the sealant material on the lower thoracic spinal cord and nerve roots.
This case report describes the potential for significant spinal cord and nerve root compression as well as the development of chronic neuralgia with the placement of epidural hydrogel and fibrin glue sealants.
Careful consideration should be taken into the needle gauge, needle position, injectate volumes, and injection velocity when delivering the sealant to the epidural space.
Use of an 18-gauge Tuohy needle with a slow but steady injection pressure, constant patient feedback, and a conservative injectate volume (less than 2 ml per level) may best optimize sealant delivery to minimize the risk of spinal cord compression and neurologic injury.
American Psychological Association (APA)
Hillegass, Michael G.& Luebbert, Samuel F.& McClenahan, Maureen F.. 2018. Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned. Case Reports in Anesthesiology،Vol. 2018, no. 2018, pp.1-5.
https://search.emarefa.net/detail/BIM-1137027
Modern Language Association (MLA)
Hillegass, Michael G.…[et al.]. Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned. Case Reports in Anesthesiology No. 2018 (2018), pp.1-5.
https://search.emarefa.net/detail/BIM-1137027
American Medical Association (AMA)
Hillegass, Michael G.& Luebbert, Samuel F.& McClenahan, Maureen F.. Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned. Case Reports in Anesthesiology. 2018. Vol. 2018, no. 2018, pp.1-5.
https://search.emarefa.net/detail/BIM-1137027
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1137027