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Blood Patch for Spinal Headaches

Blood Patch for Spinal Headaches

What is a blood patch and how is it administered?

An epidural blood patch places your own blood in the spinal canal close to the same site where your treatment was done.  To administer a blood patch, the anesthesiologist inserts a needle into the same space as, or right next to, the area in which the anesthetic was injected. The doctor then takes a small amount of blood from the patient and injects it into the epidural space. This blood forms a clot or “patch” over the area that is leaking.

What is a spinal headache?

A spinal headache can occur as a result of a procedure, usually performed by a neurologist, such as a spinal anesthetic, lumbar puncture (spinal tap), or a myelogram. During these procedures, when a needle is placed within the fluid-filled space surrounding the spinal cord it creates a passage for the spinal fluid to leak out, decreasing the pressure of the spinal fluid.  This low pressure can cause a headache often known as a spinal headache. A spinal headache may occur up to five days after a procedure is performed.

How are spinal headaches treated?

The first course of treatment for spinal headaches involves supplying adequate hydration to try to increase cerebral spinal fluid (CSF) pressure. Sometimes intravenous fluids (fluids administered into the veins) are given; other times the person is advised to drink a beverage high in caffeine. Strict bed rest for 24-48 hours is also recommended.  In addition, if your doctor believes you have a low-pressure headache, he or she may suggest an epidural blood patch.

What happens  during a blood patch procedure?

  • Before the treatment, patients are asked to notify the staff if they take (or have taken) any blood thinning medications and the last time they had anything to eat or drink. The patient is then prepped for the procedure.
  • The doctor will explain the treatment and answers any questions.
  • Patients may receive medication through an IV to help with relaxation.
  • For the treatment, patients sit with their back hunched over, or lie on their side with their knees curled up toward their chest.  (These positions help in placing the epidural needle.)
  • Next, the anesthesiologist will clean off the patient’s back with an antiseptic solution and cover it with a sterile drape.
  • After injecting some numbing medicine, a thin needle is placed into the patient’s back close to where the other treatment was done.
  • A small amount of blood is drawn from the patient’s arm and injected right away through the epidural needle into the patient’s back.  The patient may feel some minor pain or pressure in their back while it is being injected.
  • After 1 hour of rest in the recovery area and stable vital signs, patients are discharged.

What should I do after a blood patch procedure?

After a blood patch, patients are encouraged to lie flat in bed for 4 hours and restrain from lifting heavy objects for at least two days. Some patients experience pain or pressure in their back and have weakness in their legs for several hours.  Patients should not walk unassisted until their legs feel normal again and may need someone at home to assist with daily activities.

Driving is prohibited for the first 24 hours following the procedure.