Epidural Blood Patch
Meet Richard, Tucson grandfather
One possible side effect of a lumbar puncture is a headache resulting from leakage of spinal fluid. Patients like Richard can come to Radiology Ltd. in Tucson for a quick and easy fix to seal the leak. Called an epidural blood patch, the procedure involves taking a small amount of the patient’s blood from their arm and then injecting it into the epidural space near the original puncture site. The patient’s own blood effectively seals the leak, relieving the headache immediately. Just a tiny bandage and patients like Richard are on their way home and back to their usual activities.
An epidural blood patch is a procedure in which your own blood is injected into the epidural space in your lower back in order to close tears in the dura, a thin membrane that surrounds the brain and spinal cord.
This procedure often provides immediate relief from headaches caused by leaking spinal fluid, which can occur following a recent lumbar puncture (spinal tap). A small amount of blood is injected into the epidural space near the site of the original puncture, resulting in a blood clot. Working as gelatinous glue, the blood clot “patches” the dural hole, preventing additional spinal fluid leakage and allowing the hole to fully heal.
You will be asked not to eat for 6 hours prior to the procedure. You may have clear liquids up to 2 hours before the procedure but should eat nothing after that.
If you are taking prescribed anticoagulants (blood thinners) such as Coumadin or Plavix, you should ask your physician for instructions prior to the procedure. Patients should not take over-the-counter aspirin or aspirin-containing medications for at least 5 days prior to their procedure. Please consult with your doctor or healthcare provider before stopping ANY medications.
Please arrive for your procedure with a responsible adult who can drive you home.
After you arrive for your appointment, you will be escorted to a procedure room, where you will be asked to change into a patient gown. An intravenous line will be placed in your arm so that blood can be easily withdrawn when needed. You will be positioned on an exam table, and fluoroscopy will be used to determine the most appropriate needle entry site. The radiologist will cleanse the overlying skin, and a small amount of local anesthetic (lidocaine) will be injected with a small needle. You will feel a tiny pinch similar to a pinprick while the anesthetic is injected.
After the area becomes numb, the radiologist will insert a needle into the spinal canal while observing under fluoroscopy to ensure proper placement. After the needle has been properly positioned, a small amount of contrast material will be injected to confirm the needle tip is properly positioned in the epidural space before any blood is injected. After this is confirmed, blood will be withdrawn from the IV in your arm and injected into the epidural space. The needle will then be removed. A bandage will be placed over the insertion site, and you will be transported to the recovery area.
The contrast agent is an iodine-based material. Radiology Ltd. uses only non-ionic contrast agents (the safest kind), but with all contrast agents there is always the potential for allergic reaction. Be sure to tell your technologist if you have experienced a reaction to contrast material in the past. If you are diabetic and take Glucophage, Glucovance, or any other type of metformin medication to regulate your diabetes, you will need to stop taking it for 48 hours after your exam.
After being monitored for a short time, you will be released with discharge instructions. The entire procedure usually takes about 30-45 minutes.
For your safety and the protection of others, we do not allow anybody except patients in our exam rooms.
Significant complications related to an epidural blood patch are very uncommon. The primary risks associated with this procedure include:
- Allergic reaction to the contrast material
Most epidural blood patches are very well tolerated, with minimal discomfort afterwards that is usually easily controlled with non-prescription pain medication. You may apply ice to the needle insertion site to reduce swelling if necessary. Symptoms usually disappear within 48 hours; contact your physician or healthcare provider if they persist for more than two days.