Korean J Anesthesiol.  1973 Dec;6(2):237-240.

Epidaral Blood Patch for Postlumbar Puncture Headache ( Clinical Experience and Possible Complications )

• Cheun JK
• Jung JG

Abstract

Autologous blood injected into the epidural space of 10 patients with a postlumbar puncture headache resulted in immediate and lasting cure except for one patient, due to technical failure to obtain proper identification for epidural injection. No serious complications were noticed in these cases except one who developed severe lower back pain radiating to the right leg immediately after epidural injection. A headache is the commonest untoward complication of spinal puncture. The clinical applications of many of the methods of treating post lumbar puncture headaches have been most unsatisfactory. This method of treating postspinal headaches, which has only been introduced recently, namely epidural blood patch, has resulted in immediate, satisfactory and permanent relief. It is to be noted that possible additional complications may be produced. therefore an absolute indication must be evaluated to avoid additional complications before the blood patch method is used. The amount of blood and the site of injection must be considered as an important factor to prevent post blood patch complications. The possible complications from autologous blood injections into th eepidural space are as follows: 1. Nerve root compression from epidural hematoma injected for blood patch. 2. Development of epidural hematoma by injuring venous plexus. Particularly dangerous secondary problems come from patients with purpura, scurvy, hemophilia, leukemia and anticoagulant therapy. 3. Tendency of epidural abscess caused by the blood being a good media for bacterial growth. 4. Localized back pain and lumbago. 5. Persistent headache aggravated by inadvertent subdural puncture. 6. Possibility of adhesive arachnoiditis.

MeSH Terms

Adhesives
Arachnoid
Arachnoiditis
Back Pain
Blood Patch, Epidural
Epidural Abscess
Epidural Space
Headache*
Hematoma
Hemophilia A
Humans
Injections, Epidural
Leg
Leukemia
Low Back Pain
Methods
Punctures*
Purpura
Radiculopathy
Scurvy
Spinal Puncture
Adhesives