• Eun Young Joo, Bo Young Hwang, Yu Gyeong Kong, Jong Hyuk Lee, Beom Sang Hwang, and Jeong Hun Suh.
• From the *Asan Medical Center and College of Medicine, University of Ulsan, Pungnap-dong, Seoul, Korea; and †Lynn Women's Hospital, Jangan-dong, Seoul, Korea.
• Reg Anesth Pain Med. 2015 Jan 1;40(1):58-61.

Background And ObjectivesSpontaneous intracranial hypotension (SIH) is characterized by a severe and disabling headache that is usually orthostatic in nature. Cisternography is a useful diagnostic test for evaluating the presence and location of cerebrospinal fluid (CSF) leakage, and a targeted epidural blood patch (EBP) based on the cisternography findings is a very effective treatment modality for SIH. However, the effects of EBPs are not predictable, making repeat EBPs essential in some cases. The aim of the present study was to find the relationship between the EBP response and cisternographic findings, hypothesizing that the number of required EBPs would increase with an increased number of CSF leakage levels as determined by radionuclide cisternography.MethodsAll patients who underwent an EBP and had been discharged with significant improvements in symptoms of SIH during 2006 to 2011 were enrolled. Patients who had no radionuclide cisternographic results were excluded. The demographic variables, number of EBPs, cisternographic findings (location, bilaterality, and number of leakage sites), and preprocedural and postprocedural pain scores were reviewed.ResultsThere was no correlation found between the cisternographic findings and the number of EBPs. Only the preprocedural pain scores showed a statistically significant correlation with the number of EBPs.ConclusionsOur study suggests that the response to the EBP is related to the severity of symptoms but not to the number and locations of cisternographic CSF leakages.

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