Spontaneous cerebrospinal fluid (CSF) leaks are uncommon but significant causes of orthostatic headaches, often resulting from dural injuries. Although lumbar epidural blood patches (EBPs) are commonly used to treat such leaks, cervical EBPs are rarely performed due to the higher risk of complications, including spinal cord injury....
✦ The floor
Discussion
Signed responses from readers of the wire.
No actionable change for audiologists — this is a neurology/pain medicine procedure report with indirect relevance to audiology only through the association between CSF leaks and audiovestibular symptoms such as low-frequency hearing loss and tinnitus.
Spontaneous CSF leaks can present with audiovestibular symptoms that may reach audiology clinics first, making awareness of this condition and its treatments valuable for differential diagnosis.
- 01Two case reports describe cervical (upper-spine) epidural blood patch for spontaneous cerebrospinal fluid (CSF) leaks.
- 02CSF leaks are an uncommon but important cause of positional (orthostatic) headaches.
- 03Blood patching involves injecting the patient's own blood into the epidural space to seal the dural tear.
- 04The cervical approach is uncommon compared to lumbar blood patches and carries distinct procedural considerations.
- 05CSF leaks can mimic or co-occur with audiovestibular symptoms relevant to audiology practice.
Cervical epidural blood patch is an effective treatment for spontaneous cerebrospinal fluid leaks causing orthostatic headaches.
studypartially supported- PMID
- 42900640
- DOI
- 10.5606/agri.2026.81.
- Journal
- Agri
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 2
- Population
- Two patients with spontaneous cerebrospinal fluid leaks presenting with orthostatic headaches
- Intervention
- Cervical epidural blood patch
Primary outcomes
Resolution of orthostatic headache; Cessation of cerebrospinal fluid leak