Turkish Neurosurgery 2015 , Vol 25 , Num 1
Treatment of Spontaneous Intracranial Hypotension with Intravenous Factor X Administration: Initial Clinical Experience
Kimihiro NAGATANI, Satoru TAKEUCHI, Kojiro WADA, Kentaro MORI, Katsuji SHIMA
National Defense Medical College, Department of Neurosurgery, Tokorozawa, Japan DOI : 10.5137/1019-5149.JTN.9849-13.1 AIM: Coagulation Factor XIII plays an important role in wound healing by stabilizing the fibrin clot. We hypothesized that Factor XIII administration might promote the repair of cerebrospinal fluid leak sites and lead to resolution of the orthostatic headache in patients with spontaneous intracranial hypotension (SIH). The aim of this study was to investigate the efficacy of intravenous Factor XIII administration in SIH patients.

MATERIAL and METHODS: A retrospective review of nine patients (four men, five women; mean age 42.3 yr) with SIH resistant to conservative treatment (bed rest, hydration and analgesics) was performed. All patients had an orthostatic headache. Intravenous administration of Factor XIII (1200 units per day for at least five days) was additionally performed on all patients.

RESULTS: The orthostatic headache completely resolved and never reoccurred in six patients (67%), and partially resolved in two patients (22%). One patient (11%) had no change in headache activity. No complications occurred in any patients treated with Factor XIII.

CONCLUSION: This study may suggest that intravenous administration of Factor XIII is useful for treating SIH, even if the patients are resistant to conservative treatment. Keywords : Spontaneous intracranial hypotension, Factor XIII, Orthostatic headache, Conservative treatment, Epidural blood patch

Corresponding author : Kimihiro Na Gatan, naval.kimi@gmail.com