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An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak. [ 6 ] [ 7 ] [ 8 ] A spontaneous spinal cerebrospinal fluid leak may occur sometimes in those with predisposing heritable connective tissue disorders including Marfan syndrome and Ehlers–Danlos syndromes .
Lumbar punctures may also be done to inject medications into the cerebrospinal fluid ("intrathecally"), particularly for spinal anesthesia [10] or chemotherapy. Serial lumbar punctures may be useful in temporary treatment of idiopathic intracranial hypertension (IIH). This disease is characterized by increased pressure of CSF which may cause ...
A lumbar puncture that drains CSF may also be used as part of treatment for some conditions, including idiopathic intracranial hypertension and normal pressure hydrocephalus. [1] Lumbar puncture can also be performed to measure the intracranial pressure, which might be increased in certain types of hydrocephalus.
Occasionally a temporary drain is placed for 24-48 hours post op. In recurrent cases a craniotomy may be performed to attempt to locate the location of the CSF Leak. In certain cases a shunt can be placed for additional drainage. Great caution is used when choosing to look for the CSF leak due to them generally being difficult to spot.
This type of drain is known as an external ventricular drain (EVD). [10] This is rarely required outside brain injury and brain surgery settings. [citation needed] In situations when only small amounts of CSF are to be drained to reduce ICP's (e.g. in idiopathic intracranial hypertension), drainage of CSF via lumbar puncture can be used as a ...
Lumbar–peritoneal shunts are used in neurological disorders, in cases of chronic increased intracranial pressure to drain excess cerebrospinal fluid (CSF) from the Subarachnoid cavity associated with such conditions as hydrocephalus and Benign intracranial hypertension (BIH) also known as idiopathic intracranial hypertension (IIH) and ...
Radionuclide cisternography may be used to diagnose a spinal cerebrospinal fluid leak. CSF pressure is measured and imaged over 24 hours. [2] A radionuclide (radioisotope) is injected by lumbar puncture (spinal tap) into the cerebral spinal fluid to determine if there is abnormal CSF flow within the brain and spinal canal which can be altered by hydrocephalus, Arnold–Chiari malformation ...