Okpara Robin, Agyare Kofi, Ho Daniel, Psaromatis Kirie, Rodenko George
Radiology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, USA.
Radiology, Medical Center Hospital, Odessa, USA.
Cureus. 2024 Aug 26;16(8):e67860. doi: 10.7759/cureus.67860. eCollection 2024 Aug.
Although rare, cerebrospinal fluid (CSF) leaks can prove to be detrimental if severe. Usually secondary to dural punctures, CSF leaks can present as severe headaches, neck pain, blurry vision, confusion, and nausea. However, patients can also be asymptomatic. Due to the rarity and variability in symptom presentation, the diagnosis of these leaks is often missed. We present a case of a 15-year-old female who had been experiencing severe headaches after she hyperextended her neck during a horseback ride. On diagnostic imaging, a CT myelogram confirmed a CSF leak with contrast extravasation along the left T9 nerve root up to the T3-T4 levels. After confirmation, the patient received an epidural blood patch, with 15 ml of autologous blood injected into the epidural space. After the procedure, the patient experienced significant symptomatic relief, resulting in an 80% improvement in her pain scale. Our case demonstrates how a prompt and accurate diagnosis of a CSF leak can optimize patient outcomes.
虽然脑脊液（CSF）漏很少见，但如果情况严重，可能会造成损害。脑脊液漏通常继发于硬脊膜穿刺，可表现为严重头痛、颈部疼痛、视力模糊、意识模糊和恶心。然而，患者也可能没有症状。由于其罕见性和症状表现的多样性，这些漏症的诊断常常被漏诊。我们报告一例15岁女性病例，她在骑马时颈部过度伸展后一直经历严重头痛。在诊断性影像学检查中，CT脊髓造影证实存在脑脊液漏，造影剂沿左T9神经根外渗至T3 - T4水平。确诊后，患者接受了硬膜外血贴疗法，将15毫升自体血注入硬膜外间隙。术后，患者症状明显缓解，疼痛评分改善了80%。我们的病例表明，对脑脊液漏进行及时准确的诊断可优化患者的治疗效果。
