"Epidural blood patches are a treatment option for patients with craniospinal hypotension or post-dural puncture headaches in which small volumes of autologous blood are injected into a patient's epidural space to stop cerebrospinal fluid leak. The procedure can be done blind or under imaging (fluoroscopy or CT) guidance and is performed predominantly by radiologists and anaesthetists."
"craniospinal hypotension including post-dural puncture headache and spontaneous intracranial hypotension"
"Post-procedural management"
"Patients should be supine for 2 hours post-EBP to promote clot formation at the site of the dural tear. Vigorous exercise, long travel and constipation which may increase the risk of dislodging the blood clot or headache recurrence should be avoided9."
"The success rate of non-targeted epidural blood patch is variable, reported between ~75% (range 50-95%) for craniospinal hypotension and ~95% (range 90-99%) for post-dural puncture headache. In successful procedures, the patient's symptoms will objectively improve (some only temporarily), and the imaging features of craniospinal hypotension will reverse 1,4,5. Sometimes multiple blood patches are required for a successful outcome."
"Patients should be supine for 2 hours post-EBP to promote clot formation at the site of the dural tear. Vigorous exercise, long travel and constipation which may increase the risk of dislodging the blood clot or headache recurrence should be avoided9."
"The blood is then slowly injected checking frequently with the patient for symptoms and performing neurological observations on the feet. The volume injected depends on the location and size of the epidural space. It can be low (e.g. 2-3 mL when performing targeted multi-needle thoracic injection) or high (e.g.10-25 mL in non-targeted lumbar epidural injection in capacious canals)."
"Patients should be supine for 2 hours post-EBP to promote clot formation at the site of the dural tear. Vigorous exercise, long travel and constipation which may increase the risk of dislodging the blood clot or headache recurrence should be avoided9."
Expected headings
"Cannulation"
"Epidural access"
"Interlaminar approach"
"Transforaminal approach"
"Injection"
"Post-procedural management"
"Once the epidural space is entered, extravascular and extrathecal location is confirmed with the injection of a small amount of contrast."
"The blood is then slowly injected checking frequently with the patient for symptoms and performing neurological observations on the feet. The volume injected depends on the location and size of the epidural space. It can be low (e.g. 2-3 mL when performing targeted multi-needle thoracic injection) or high (e.g.10-25 mL in non-targeted lumbar epidural injection in capacious canals)."
"transient back pain: most common; pain may last up to 4 weeks 6"