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Background <p>The influence of age on the management of spontaneous intracranial hypotension (SIH), particularly epidural blood patch (EBP), remains unclear. This study aims to characterize age-related differences in clinical manifestation, neuroimaging features, and treatment outcomes.</p> Methods <p>In this retrospective cohort study, we analyzed 54 SIH patients who underwent EBP at our center. Patients were classified into two groups based on the cohort median age (35 years). Demographic, clinical, neuroimaging features, and treatment outcomes were compared between the two groups. We further utilized Spearman correlation, locally weighted scatterplot smoothing, and multivariable linear regression to analyze the association between age and EBP volume. Several sensitivity analyses were conducted to assess the robustness of our findings.</p> Results <p>Among 54 enrolled patients, the injected volume of EBP was markedly larger in the older group (26.00 [19.12, 32.75] vs. 19.25 [15.00, 24.00] ml, <i>P</i> = 0.018). While Spearman correlation indicated a significant positive correlation existed between age and EBP volume (ρ = 0.388, <i>P</i> = 0.004), subgroup analysis revealed a dissociation: a strong linear correlation in the older group (ρ = 0.458, <i>P</i> = 0.018) contrasted with a non-significant, non-monotonic trend in the younger group (ρ = -0.034, <i>P</i> = 0.863). Linear regression analysis showed that age was positively associated with EBP volume (β = 2.899, 95% confidence interval: 0.475–5.322, <i>P</i> = 0.023).</p> Conclusion <p>These findings highlight the potential utility of considering patient age when planning EBP procedures, suggesting that age-adapted volume strategies may optimize treatment and warrant further investigation.</p>

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Age-related differences in clinical manifestations, neuroimaging features, and treatment of spontaneous intracranial hypotension: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月23日

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  • Xiaohang Dong,
  • Qirui Liu,
  • Sichen He,
  • Guohui Huang,
  • Wangdi Huang,
  • Letao Zhang,
  • Bin Chen,
  • Wei Xie,
  • Suyue Pan,
  • Yabin Ji

摘要

Background

The influence of age on the management of spontaneous intracranial hypotension (SIH), particularly epidural blood patch (EBP), remains unclear. This study aims to characterize age-related differences in clinical manifestation, neuroimaging features, and treatment outcomes.

Methods

In this retrospective cohort study, we analyzed 54 SIH patients who underwent EBP at our center. Patients were classified into two groups based on the cohort median age (35 years). Demographic, clinical, neuroimaging features, and treatment outcomes were compared between the two groups. We further utilized Spearman correlation, locally weighted scatterplot smoothing, and multivariable linear regression to analyze the association between age and EBP volume. Several sensitivity analyses were conducted to assess the robustness of our findings.

Results

Among 54 enrolled patients, the injected volume of EBP was markedly larger in the older group (26.00 [19.12, 32.75] vs. 19.25 [15.00, 24.00] ml, P = 0.018). While Spearman correlation indicated a significant positive correlation existed between age and EBP volume (ρ = 0.388, P = 0.004), subgroup analysis revealed a dissociation: a strong linear correlation in the older group (ρ = 0.458, P = 0.018) contrasted with a non-significant, non-monotonic trend in the younger group (ρ = -0.034, P = 0.863). Linear regression analysis showed that age was positively associated with EBP volume (β = 2.899, 95% confidence interval: 0.475–5.322, P = 0.023).

Conclusion

These findings highlight the potential utility of considering patient age when planning EBP procedures, suggesting that age-adapted volume strategies may optimize treatment and warrant further investigation.