J Korean Soc Radiol.  2018 Apr;78(4):242-248. 10.3348/jksr.2018.78.4.242.

The Efficacy of a Fluoroscopy Guided Epidural Autologous Blood Patch In the Treatment of a Post-Dural Puncture Headache

• Park JE
• Lee E
• Lee JW
• Kang Y
• Ahn JM
• Kang HS

• KMID: 2407929
• DOI: http://doi.org/10.3348/jksr.2018.78.4.242

Abstract

PURPOSE
To evaluate the efficacy of a fluoroscopy-guided epidural blood patch (EBP) in the treatment of a post-dural puncture headache (PDPH).
MATERIALS AND METHODS
From November 2013 to April 2017, a total of 164 patients (76 males, 88 females, mean age 40.7 years, age range 12 to 87 years) underwent a fluoroscopy guided EBP for the treatment of PDPH in the department of radiology. The treatment outcomes were classified as follows: complete relief, incomplete relief, failure, and recurrence. In the case of recurrence, the duration between the date of the first EBP and the date of recurrence was described. The effectiveness of the second EBP was also evaluated.
RESULTS
In 164 PDPH patients, complete relief was achieved in 157 patients (95.8%), incomplete relief was achieved in 1 patient (0.6%), failure in 2 patients (1.2%) and recurrence in 4 patients after the first EBP. All 4 recurrence patients and the 2 failure patients were discharged with complete relief after receiving one additional EBP.
CONCLUSION
In patients with PDPH, a fluoroscopy-guided EBP is an effective treatment. Moreover, an additional EBP can be considered in the clinical failure or recurrence of PDPH after the first EBP.

MeSH Terms

Blood Patch, Epidural
Female
Fluoroscopy*
Humans
Male
Post-Dural Puncture Headache*
Recurrence

Figure

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  Fig. 1. Epidural blood patch is done at L2/3 (A), L3/4 (B), and L4/5 (C) using 10 mL autologous blood.

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  Fig. 2. Trial profile. CR = complete relief, EBP = epidural blood patch, IR = incomplete relief

Reference

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