Epidural Blood Patch for Postdural Puncture Headache

Abstract

Postdural puncture headache is an unfortunate complication of spinal anesthesia, lumbar puncture, and myelography. Many of these headaches resolve spontaneously during the week after the procedure (1); if not, therapeutic intervention may be necessary. Many therapeutic maneuvers have been used with mixed success. The most reliable is the epidural blood patch, which since its original description (2) has become widely used in the treatment of postdural puncture headache (3–5). Most reports describe the use of an epidural blood patch within days after the onset of postdural puncture headache, and there are a few case reports describing its use for headache of up to 8 months' duration (6–8). There are none beyond this time. The following case report describes a postdural puncture headache lasting nineteen months and its ultimate successful treatment using an autologous epidural blood patch.