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Computerized tomography‐guided epidural blood patch in the treatment of spontaneous low cerebrospinal fluid pressure headache

A 54‐year‐old woman suffering from migraine for 35 years was referred to the pain clinic with a changed pattern of headache that had developed over the last 6 weeks. The pain was located in the central forehead region; aggravation in the prone and immediate relief in the supine position led to the hypothesis of a spontaneous low cerebrospinal fluid (CSF) pressure headache. Cisternography revealed a cyst‐like formation in the cervico‐thoracic region, indicating cerebrospinal fluid leakage. Magnetic resonance imaging (MRI) myelography confirmed ventral leakage but failed to locate the exact site. Computerized tomography (CT)‐guided epidural blood patching between T1 and T2 completely relieved the headache.