Abstract
We present an interesting case report of a 49-year-old female who presented with symptoms of post-dural puncture headache following implantation of an intrathecal pain pump. Her history was complicated by previous multi-level spinal fusion with hardware. The patient was evaluated and felt to be a candidate for epidural blood patch, which she elected to proceed with. Under fluoroscopic guidance epidural blood patch was successfully performed. Immediately following the procedure the patient noted significant improvement in the headache and six hours following the procedure was headache free and remained so at follow up three weeks later.
Highlights
Epidural blood patch is well described in the literature for treatment of postdural puncture headache especially in the area of obstetrical anesthesia
We present an interesting case report of a 49-year-old female who presented with symptoms of post-dural puncture headache following implantation of an intrathecal pain pump
With no epidural space, the question arises whether blood patching will be effective and by what mechanism the blood patch works in such a patient
Summary
Epidural blood patch is well described in the literature for treatment of postdural puncture headache especially in the area of obstetrical anesthesia. Little information exists on the safety and efficacy of epidural blood patch in patients with a history of spinal surgery and persistent dural compromise from devices such as an intrathecal pain pump. This case report demonstrates that epidural blood patch can be performed safely and efficaciously in a subset of these patients
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