OBJECTIVE: To describe the treatment outcomes of epidural blood patch (EBP) guided by a novel overflow leak test (OLT) combined with computed tomography myelography (CTM) in patients with intracranial hypotension, with focus on consistency and discrepancy between CTM and OLT findings. METHODS: CTM followed by OLT was performed in 18 adults with a cerebrospinal fluid pressure of ≤60 mmH RESULTS: Complete recovery following EBP was achieved for 13 (72%) patients
these included 50%, 82%, 100%, and 0% patients in Groups A, B, C, and D, respectively. In CT myelography phantoms, even 1 μL of contrast agent produced positive findings, whereas OLT phantoms required a minimum of 1000 μL. CONCLUSIONS: These results suggest the potential additive diagnostic value of OLT when performed with CTM. The discrepancy in radiological findings could be partly explained by susceptibility to the contrast agent leaking from the lumbar puncture site.