Epidural Blood Patch

What you should know

An epidural blood patch is a procedure used to relieve a headache caused by spinal fluid leak after a dural puncture. A caregiver will inject a sample of your own blood into your back, near the dural puncture site. The blood will clot, which may patch the leak. An epidural blood patch may also help reduce other spinal fluid leak symptoms, such as nausea, vomiting, hearing or vision trouble, or a stiff neck.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

Rarely, you may be at risk for an infection in the injection site. Without treatment, your spinal fluid may continue to leak. This may increase your risk of infection. Your headache may lead to a blood clot near your brain. A severe leak could lead to seizures and may be life-threatening. You may need a second blood patch procedure if a large amount of spinal fluid has leaked. You may need surgery to repair your dural damage.

Getting Ready

Before the procedure:

  • Tell your caregiver if you have a history of bleeding problems or a recent or current infection. Tell him if you have a history of headaches and what causes them.

  • You may need to have a lumbar puncture to test the level of your spinal fluid. You may need blood tests to check how well your blood clots. Caregivers may also do a CT scan or MRI. You may be given dye to help the images show up better. Tell your caregiver if you have ever had an allergic reaction to contrast dye. Ask your caregiver for more information about these and other tests you may need.

  • Your caregiver may tell you to rest in bed. He may also ask you to lie flat on your back if this is comfortable for you.

  • You may be given caffeine to drink or as a medicine through an IV. Caffeine causes your veins to constrict (narrow), which could help improve your symptoms.

  • You may be given medicine to decrease pain and nausea.

  • Ask your caregiver how much liquid you should drink before this procedure, and which liquids are best for you.

  • Arrange to have someone drive you home after your procedure.

The day of the procedure:

You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

Your caregiver will ask you to sit down, lie on your side, or lie on your stomach. He will locate the area of your spine where he will inject the blood. This will likely be right below your dural puncture site. Your caregiver will draw blood from a vein in your arm. He will then slowly inject the blood into the area of your spine near the puncture site. Tell your caregiver if you feel back or neck pain, or pain that spreads down your legs. Also tell your caregiver if your headache gets worse or you feel pressure.

After the procedure:

  • You will need to lie still and flat on your back for about 2 hours after your procedure. If this is a second procedure, you may need to lie flat for up to 24 hours. You may be directed to elevate your legs. Do not get up to walk until caregivers tell you it is okay.

  • Your headache may improve immediately or within a few days. You may have mild back, neck, or leg pain, or a slight fever for 1 to 2 days after your procedure. Ask your caregiver if you may use NSAIDs for pain or fever.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have questions about your symptoms or procedure, or your headache goes away.

  • You have a fever.

  • You have a raised, fluid-filled bump or a rash on your lower back.

Seek Care Immediately if

  • You have new or worse nausea or vomiting.

  • You feel confused, more tired than usual, or you have new problems with your movement or walking.

  • You have new or worsening ringing in your ears, hearing trouble, or are more sensitive to sound.

  • You have a burning or tingling feeling on your scalp, or arm or leg pain.

  • You cannot control when you urinate or have a bowel movement.

  • You have a seizure.

  • You have watery fluid draining from your nose or down your throat.

  • Your headache gets worse, or you feel pain in one area of your head instead of all over your head. The pain may also move to another area of your head.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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