• Hung-Chieh Chen, Tsung-Wei Hou, Po-Lin Chen, Chih-Cheng Wu, Shuu-Jiun Wang, and Yen-Feng Wang.
• Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
• J Chin Med Assoc. 2024 Dec 12.

BackgroundEpidural blood patching (EBP) is the primary treatment for spontaneous intracranial hypotension (SIH), although multiple attempts may sometimes be necessary. The SIH-EBP score, with a cutoff of ≥3, predicts the response to the first EBP. However, its generalizability requires further confirmation. This study aims to validate the clinical utility of the SIH-EBP score and determine the optimal cutoff for predicting the response to the first EBP in an independent cohort of SIH patients.MethodsThis retrospective study included patients with SIH who received at least one EBP at a tertiary medical center. Clinical data were extracted from electronic medical records, and brain and spinal magnetic resonance images were reviewed.ResultsNinety-six patients (58F/38M, mean age 42.67 ± 10.16 years) were screened, with 49 analyzed (32F/17M, mean age 41.20 ± 9.13 years), including 30 responders (22F/8M, mean age 41.10 ± 10.14 years) (61.2%). There was a positive correlation between SIH-EBP scores and responder rates (p=0.001). A cutoff score of ≥3 was associated with a higher response rate than <3 (80.0% vs. 41.7%, p=0.006) (sensitivity=73.7%, specificity=66.7%, accuracy=69.4%). The optimal cutoff in this cohort was ≥2 (AUC=0.77, p<0.0001) (sensitivity=52.6%, specificity=90.0%, accuracy=75.5%).ConclusionIn this cohort, the SIH-EBP score correlated with response rates to the first EBP. Although a score of ≥3 remains a valid predictor of treatment response, a cutoff of ≥2 proved to be more accurate and specific. However, its practical use is limited by a sensitivity of 52.6%. Further studies are needed to verify its role in other populations.Copyright © 2024, the Chinese Medical Association.

6 keywords...

hide…