I didn’t have to wait long in the procedure waiting room before a nurse called me back to the prepping area.
Spontaneous cerebrospinal fluid leak specialist Patch#
Preparing for the Blood Patch In pre-op preparing for my first blood patch It’s important to pay attention to certain restrictions in movement following a blood patch. There could be other factors as well, including not being careful enough to protect the patch once it’s placed. The patch may be blind, or non-targeted, if the leak site is unknown the blood may not reach the leak. Failure may be due to not enough blood being injected ( studies have shown³ that high volume patches above 20 mL are most successful). For spontaneous leaks, studies have shown² that a blood patch is 30% effective. Unfortunately, blood patches don’t always work. This effect is often delayed however, variability is substantial. (This is by far not an occurrence in every case.)Īs a secondary mechanism, the blood patch will (hopefully) seal the hole in the dura, somewhat like putting a bandage over a hole in a rubber hose. Patients may experience an immediate relief of symptoms due to this effect. This pushes the CSF up into the brain and lifts the brain. When blood is injected into the epidural space, there is an immediate volume displacement¹ where the dura is squeezed by the presence of the blood.
(My leak is spontaneous.) How Does a Blood Patch Work? Post Patch Restrictions Holes in the dura can be caused by lumbar punctures, accidental punctures during placement of an epidural needle, spinal surgery, or spontaneous leaks. When there is a hole in the dura, CSF fluid leaks out, causing the brain to sag in the head, resulting in numerous symptoms and sometimes causing complete debilitation. This fluid flows around the brain and spinal cord and cushions, or floats, the brain in the head. This space is located just outside the dura mater, which is a tough, fibrous membrane that keeps cerebrospinal fluid (CSF) contained. My MRI imaging was read as normal, so in the eyes of my doctors, I needed this patch to work to prove I had a leak.ĬW: Blood, needles, detailed description of medical procedure What is a Blood Patch?Īlso known as an epidural blood patch, this procedure involves injecting a patient’s own blood into the epidural space in the spine. If the blood patch worked, it would be more or less diagnostic of a spinal CSF leak. I was there to have an epidural blood patch for a suspected spinal CSF leak.
It was a warm summer morning when I arrived at the pain management center.
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