Epidural Patching [Neurosurgery Wiki]

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====== Epidural Patching ======


===== 💉 Indications =====

see [[Epidural Patching For Lateral Dural Tears In Spontaneous Intracranial Hypotension]]

✅ General Clinical Indications

[[Spontaneous Intracranial Hypotension]] (SIH)

Caused by spinal CSF leak

Classic symptoms: orthostatic headache, nausea, dizziness, tinnitus, blurry vision

MRI findings: diffuse pachymeningeal enhancement, brain sagging, venous engorgement

Post-Dural Puncture Headache (PDPH)

After lumbar puncture or spinal anesthesia

Indicated if persistent, disabling headache >24–48 hours

Iatrogenic CSF Leak

Following spinal surgery, nerve root blocks, or dural biopsies

Targeted Patching for Localized CSF Leaks

When the exact leak site is identified via MRI or myelography

Especially useful in ventral or lateral dural tears associated with SLECs