Epidural blood patch
An epidural blood patch is a surgical procedure that uses autologous blood in order to close one or many holes in the dura mater of the spinal cord, usually as a result of a previous lumbar puncture. The procedure can be used to relieve post dural puncture headaches caused by lumbar puncture (spinal tap). A small amount of the patient's blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. The procedure carries the typical risks of any epidural puncture. However, even though it is often effective,[1] further intervention is sometimes necessary.
An epidural needle is inserted into the epidural space at the site of the cerebrospinal fluid leak and blood is injected. The clotting factors of the blood close the hole in the dura.
As such, the autologous blood does not "repair" the leak, but rather treats the patient's symptomology.
It is also postulated that the relief of the headache after an epidural blood patch is due to more of a compression effect than sealing the leak. Because the fluid column in the lumbar spine is continuous with the fluid around the brain, the blood exerts a "squeeze" and relieves the low pressure state in the head.
References
- ↑ Safa-Tisseront V, Thormann F, Malassiné P, et al. (August 2001). "Effectiveness of epidural blood patch in the management of post-dural puncture headache". Anesthesiology 95 (2): 334–9. doi:10.1097/00000542-200108000-00012. PMID 11506102.