Spontaneous CSF leak treated with percutaneous CT-guided fibrin glue

Spontaneous intracranial hypotension (SIH) is characterized by CSF hypovolemia usually occurring secondary to a spontaneous breech in the spinal dura mater. While patients with SIH often recover spontaneously or with autologous epidural blood patch (EBP), up to 1/3 of patients fail to respond to repeated EBP. While surgical therapy can be curative in these cases if the leak can be localized, the cost, morbidity, and difficulty identifying the site of the CSF leak during surgery makes this option less than optimal.1 We report a patient with a persistent symptomatic CSF leak who recovered following a percutaneous CT-guided fibrin glue injection at the site of a CSF leak. A 44-year-old nurse was evaluated for a 3-month history of chronic daily headache. Three months prior to presentation, the patient developed five discrete episodes of exertional headache over a 10-day period. Each episode resolved completely after a night's sleep. In between …