Epidural Blood Patch Placement

Rarely, after a lumbar puncture, a patient will develop a post-lumbar puncture headache. This is a headache that is worse when the person is standing up and better when he or she is lying down. It is thought to be caused when the small hole created in the dura (the lining of the brain and spinal cord) during the lumbar puncture does not close properly. A small amount of CSF (spinal fluid) then leaks out of the hole and causes the headache. Conservative treatments such as pain medicines and caffeine are used first to try and control a post-lumbar puncture headache. If these treatments fail, an epidural blood patch is another potential treatment.

During an epidural blood patch, a small needle is advanced into the epidural space (which lies just outside the subarachnoid space). Once the needle is in the epidural space, a small amount (about 20 mL) of the patient’s own blood is withdrawn from a vein and inserted into the needle in the epidural space. The blood then clots and clogs the small hole that was causing the fluid leak and the headache.

Epidural Blood Patch Placement Image

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