Spontaneous Intracranial Hypotension | Why Conservative Treatment Fails I Dr. Pramod Apsingekar

#EpiduralBloodPatch #SpontinteousIntracranialHypotension #OrthostatiHeadache #DrPramodApsingekar

00:00 - Intro
00:44 - Case Presentation
02:40 - Intracranial Hypotension
03:39 - Physiology of CSF Pressure
04:32 - Causes Of Spontaneous Intracranial Hypotension(SIH)
06:48 - Clinical Features of SIH
08:27 - Investigations For SIH
09:22 - Differential Diagnosis
09:57 - Treatment Options
11:26 - Epidural Blood Patch
13:08 - Procedure - Epidural Blood Patch
15:27 - Complications Of Epidural Blood Patch
17:12 - Case Series of Epidural Blood Patch
20:08 - Results Of Epidural Blood Patch
20:37 - Review Of Literature
25:40 - Conclusion

Imagine a headache so severe and so characteristic that it strikes the moment you sit up and disappears the instant you lie flat — this is the hallmark of Spontaneous Intracranial Hypotension (SIH), a condition caused by spontaneous spinal CSF leakage that is frequently under diagnosed and often mistaken for migraine or tension headache. SIH occurs when spontaneous tears in the dura mater allow cerebrospinal fluid to leak into the spinal epidural space, dropping CSF pressure to ≤6 cmH₂O and triggering the classic orthostatic headache that worsens on standing and resolves on lying down, often accompanied by tinnitus, diplopia, nausea, and neck stiffness. While conservative management — bed rest, oral hydration, caffeine, and NSAIDs — is tried first, the most effective interventional treatment is the Epidural Blood Patch (EBP), where 15–20 mL of autologous blood is injected into the epidural space to seal the dural defect, mechanically plug the leak, and restore CSF pressure through a tamponade effect. A single blind EBP achieves clinical success in approximately 60–70% of cases, rising above 90% with a second targeted patch — and in refractory cases, higher-volume or multi-level catheter-guided EBP techniques have shown promising results. In this compelling session, Dr. Pramod Apsingekar presents a detailed case series of patients treated with EBP for SIH, sharing real-world outcomes, procedural insights, and lessons drawn from an extensive review of literature — making this a must-watch for every anaesthesiologist involved in perioperative or pain management practice.

This session is highly relevant for anaesthesiologists, pain physicians, neurologists, and all clinicians who encounter patients with postural headache, CSF leak syndromes, or dural puncture complications.

About Ozone Learning Academy:
Ozone Learning Academy is the academic initiative of the Ozone Anaesthesia Group, offering weekly Thursday evening sessions on clinically relevant anaesthesia and perioperative topics by expert faculty, for continuous professional development.

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Epidural blood patch, Spontaneous intracranial hypotension, Orthostatic headache treatment, CSF leak headache, Post dural puncture headache, Intracranial hypotension treatment, Dr Pramod Apsingekar, Ozone Learning Academy, Ozone Anaesthesia Group, SIH treatment, Epidural blood patch procedure, CSF pressure physiology, EBP complications, Blood patch case series, Headache anesthesia
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Credits
Video Editing- Vipul Tribhuwan/Dr. Sujitkumar Khade
Concept & Thumbnail - Dr. Sujitkumar Khade
Production- Ozone Anaesthesia Group

Видео Spontaneous Intracranial Hypotension | Why Conservative Treatment Fails I Dr. Pramod Apsingekar канала Ozone Learning Academy