FAQs on Epidural Blood Patch in Atlanta

A post-dural puncture headache (PDPH) occurs in up to 40% of patients who undergo lumbar puncture. This type of headache is severe and debilitating. An epidural blood patch is the treatment of choice for PDPH, with many studies showing that 90-100% of patients enjoy a rapid recovery after this procedure.

What causes the headache that occurs after a lumbar puncture?

PDPH is thought to be the result of cerebrospinal fluid (CSF) through the punctured dura into the epidural space. This leakage causes a decrease in CSF pressure and volume, which produces traction on various pain-sensitive structures when the patient is in the upright position. This type of headache is worse when the patient is vertical and relieved when the patient is lying horizontally.

What symptoms are associated with PDPH?

Besides having a headache, the patient often experiences ringing of the ears, double vision, dizziness, and muscle aches. Most headaches occur within 48 hours of the procedure. For many patients, these symptoms are self-limiting, but for 20% of the cases, the symptoms persist for weeks or months.

What should I expect before the procedure?

Before the epidural blood patch, the doctor will conduct a thorough physical examination and explain the associated risks and benefits of the procedure. Be sure to ask the doctor which medications you should take and which ones you should withhold before the procedure. You should not eat or drink anything 2-6 hours before the epidural blood patch, and you need to arrange for a ride home.

What happens during the epidural blood patch procedure?

Once you are in the procedure room, intravenous catheters are inserted in your arm to deliver fluids and medications, as well as to draw blood. After you are given a mild sedative, you will be positioned face down on the procedure table, and your back is cleansed with an antiseptic.

A local anesthetic is used to numb the puncture site so you do not feel any pain. Using x-ray guidance (fluoroscopy), the doctor guides a small needle into the area where the spinal fluid is leaking. The small amount of blood drawn from your arm is then injected into the leak, which clots, sealing the leakage.

Does the procedure hurt?

You are awake during the epidural blood patch. You may feel slight pressure in the back during the procedure, but no pain. However, after the procedure, your lower back may be sore and slightly tender for a few hours.

What to expect after the procedure?

After the epidural blood patch, you will be taken to a recovery area where you will be monitored for 30-60 minutes. The nurse will make you lie still and remain on your back. During this time, your vital signs are monitored and you are given IV fluids.

You are allowed to go home the same day as the epidural blood patch, where you continue bed rest for 24 hours. During the first 2-3 days of your recover, avoid any sudden movement, heavy lifting, or strenuous activity.

What are the complications associated with the epidural blood patch?

The risks and complications associated with an epidural blood patch are rare. They include reaction to anesthesia, contrast dye, or sedative medication, dizziness, bleeding, and infection.

Does the epidural blood patch work?

Several observational studies show high efficacy rates associated with the epidural blood patch. Around 70-90% of patients have complete relief of headache. If a second epidural blood patch is necessary, the effectiveness increases to 95%.