Rapid resolution of subdural hematoma after targeted epidural blood patch treatment in patients with spontaneous intracranial hypotension

Background Subdural hematoma(SDH)is a common complication of spontaneous intracranial hypotension(SIH).To date,the management of SDH caused by SIH remains controversial.In this paper,we reviewed the clinical course of SDH in patients with SIH,and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch(EBP)surgery.Methods We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology center.Patients who received early CT/MRI follow-up after EBP operation were included.Results A series of four cases of SIH complicated with SDHs were evaluated.Early follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch treatment.Conclusion Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.