A case of cerebrospinal fluid hypovolemia caused by Ommaya reservoir successfully treated by epidural blood patch
Jimbo, Y.; Uzuka, T.; Fujii, Y.
No Shinkei Geka. Neurological Surgery 36(7): 639-643
2008
ISSN/ISBN: 0301-2603 PMID: 18634407 Document Number: 617808
Here, we report a case of cerebrospinal fluid hypovolemia caused by lumbar puncture for implantation of an Ommaya reservoir. A 55-year-old man with central nervous system lymphoma developed meningeal dissemination. He was treated by spinal radiotherapy, and had an Ommaya reservoir implanted for intrathecal injection of anticancer drugs. After one month, he complained of orthostatic neck pain. MRI revealed bilateral subdural effusion and diffuse meningeal enhancement. He was diagnosed as having cerebrospinal fluid hypovolemia. Because no improvement in symptoms was seen after 2 weeks of conservative treatment, he was treated by a lumbar epidural blood patch. Subsequently symptoms improved markedly, and bilateral subdural effusion and diffuse meningeal enhancement disappeared on follow-up MRI.