{
  "abstract": "Introduction Spontaneous intracranial hypotension (SIH) is an uncommon but potentially debilitating condition, caused by cerebrospinal fluid (CSF) leaks. While the majority of patients respond to epidural blood patches (EBP), a subset remains refractory to this treatment. We report the first case of a Type 1 lateral C1–C2 cervical CSF-leak with persistent symptoms despite multiple non-targeted and targeted EBPs, successfully treated with a minimally invasive CT-guided cyanoacrylate injection.Abstract C57 Figure 1Case Description A 22-year-old woman presented with severe orthostatic headaches and tinnitus consistent with SIH. She had previously undergone two non-targeted EBPs without improvement.Myelo-MRI revealed an epidural CSF collection extending from T12 to C6.Dynamic CT myelography localized a Type 1 CSF leak at the lateral C1–C2 level. Two targeted EBPs were performed,without success.Surgical management was considered too invasive. A CT-guided percutaneous injection of 1.5cc cyanoacrylate (1:1dilution) was performed under local anesthesia.The patient experienced transient intense cervical pain.MRI at 72 hours showed early improvement.Complete resolution of intracranial hypotension and meningeal irritation symptoms occurred within seven days.At two-year follow-up, the patient remained symptom-free and had resumed triathlon training.Abstract C57 Figure 2Conclusions This case highlights the potential of a targeted cyanoacrylate patch as an effective treatment for refractory intracranial hypotension caused by type1 CSF-Leak. It offers a minimally invasive alternative when surgery is not a viable option. While complications such as intrathecal migration and significant local pain may occur, these risks can be minimized through careful technique, and precise CT guidance. Further studies are needed to confirm its safety, efficacy, and role in future treatment strategies.Abstract C57 Figure 3Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "CHU Bordeaux, Interventionnal Neuroradiology, Bordeaux, France"
      ],
      "name": "Papaxanthos Jean"
    }
  ],
  "title": "C57 Innovative management of type 1 refractory intracranial hypotension using cyanoacrylate",
  "uid": "21da8cb3-de52-55c2-ace9-989493678356"
}