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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]
Illustration depicting lumbar puncture (spinal tap) Spinal needles used in lumbar puncture Illustration depicting common positions for lumbar puncture procedure. The person is usually placed on their side (left more commonly than right). The patient bends the neck so the chin is close to the chest, hunches the back, and brings knees toward the ...
Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness .
A lumbar puncture can give the symptom of a post-dural-puncture headache. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. [5] A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak.
Quincke's puncture" is a somewhat outdated eponym for lumbar puncture, [4] [5] used for the examination of the cerebrospinal fluid in numerous diseases such as meningitis and multiple sclerosis. In 1893 he described what is now known as idiopathic intracranial hypertension , which he labeled "serous meningitis".
In labouring women, the onset of analgesia is more rapid with combined spinal and epidural anaesthesia compared with epidural analgesia. [2] Combined spinal and epidural anaesthesia in labour was formerly thought to enable women to mobilise for longer compared with epidural analgesia, but this is not supported by a recent Cochrane review.
In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence. [3] In the cervical and thoracic spine it is used to treat myelopathy caused by compression of the spinal cord itself.
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...