An epidural blood patch is a treatment for a spinal headache associated with a dural puncture, where a sample of cerebrospinal fluid is taken for analysis. In some cases, dural punctures cause changes in the pressure of the cerebrospinal fluid by creating a small leak and an epidural blood patch seals the leak, restoring the pressure and resolving the headache. This procedure is performed in a hospital or clinic and does not take very long. The patient should expect to rest for at least 24 hours after the procedure.
In a patient who has had a recent dural puncture, if a headache develops, the patient may be provided with supportive care like rest and fluids to see if the headache resolves independently. If it does not, or it grows worse, a physician may recommend an epidural blood patch. The patient will be advised to avoid eating and drinking for at least two hours before the procedure to prepare. In a treatment room, the patient will change into a hospital gown and lie on a table. An area of skin around the spine is wiped with anesthetic and a small sample of blood is taken.
The blood sample is injected into the epidural space, where the clotting factors present in the blood will act to seal the small leak created by the dural puncture. Once the leak is sealed, the patient will stop losing cerebrospinal fluid and the pressure level inside the dural space will return to normal. The low pressure present around the brain will increase to normal pressure, and the patient's headache should begin feeling much better.
On the day of an epidural blood patch, patients are usually advised to lie totally flat and rest while getting sufficient fluids. Patients can get up to use the bathroom. After the first 24 hours, patients can resume light activities if they feel able to so, and after 72 hours, they should be able to resume normal activity levels, unless they have an underlying health condition that would interfere with their abilities.
These are some risks associated with the epidural blood patch, but they tend to be very low. The biggest risk is infection. If a patient develops an infection, the site of the procedure may start to drain fluid and the patient can feel stiff and sore. Stiff neck and confusion in particular are dangerous signs of infection in patients after spinal procedures.
