Epidural blood patch
Encyclopedia
An epidural blood patch is a surgical procedure which uses autologous blood in order to close one or many holes in the dura mater
of the spinal cord
, usually as a result of a previous lumbar puncture
. The procedure can be used to relieve post dural puncture headache
s caused by lumbar puncture
(spinal tap). A small amount of the patient's blood
is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. The procedure carries the typical risks of any epidural puncture. However, it is effective, and further intervention is rarely necessary.
An epidural needle is inserted into the epidural space
at the site of the cerebrospinal fluid
leak and blood is injected. The clotting factors of the blood close the hole in the dura.
As such, the autologous blood does not "repair" the leak, but rather treats the patient's symptomology.
It is also postulated that the relief of the headache after an epidural blood patch is due to more of a compression effect than sealing the leak. Because the fluid column in the lumbar spine is continuous with the fluid around the brain, the blood exerts a "squeeze" and relieves the low pressure state in the head.
Dura mater
The dura mater , or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord. It is derived from Mesoderm. The other two meningeal layers are the pia mater and the arachnoid mater. The dura surrounds the brain and the spinal cord and is responsible for...
of the spinal cord
Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...
, usually as a result of a previous lumbar puncture
Lumbar puncture
A lumbar puncture is a diagnostic and at times therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis, or very rarely as a treatment to relieve increased intracranial pressure.-Indications:The...
. The procedure can be used to relieve post dural puncture headache
Post dural puncture headache
Post-dural-puncture headache is a complication of puncture of the dura mater...
s caused by lumbar puncture
Lumbar puncture
A lumbar puncture is a diagnostic and at times therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis, or very rarely as a treatment to relieve increased intracranial pressure.-Indications:The...
(spinal tap). A small amount of the patient's blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. The procedure carries the typical risks of any epidural puncture. However, it is effective, and further intervention is rarely necessary.
An epidural needle is inserted into the epidural space
Epidural space
In the spine, the epidural space is the outermost part of the spinal canal. It is the space within the canal lying outside the dura mater...
at the site of the cerebrospinal fluid
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
leak and blood is injected. The clotting factors of the blood close the hole in the dura.
As such, the autologous blood does not "repair" the leak, but rather treats the patient's symptomology.
It is also postulated that the relief of the headache after an epidural blood patch is due to more of a compression effect than sealing the leak. Because the fluid column in the lumbar spine is continuous with the fluid around the brain, the blood exerts a "squeeze" and relieves the low pressure state in the head.