Cervical Foraminal Epidural Blood Patch for the Targeted Treatment of Refractory Cerebrospinal Fluid Leakage From a Dural Sleeve

Reg Anesth Pain Med. 2018 Feb;43(2):205-210. doi: 10.1097/AAP.0000000000000696.

Abstract

Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen.

Publication types

  • Case Reports

MeSH terms

  • Blood Patch, Epidural / methods*
  • Cerebrospinal Fluid Leak / diagnostic imaging
  • Cerebrospinal Fluid Leak / etiology
  • Cerebrospinal Fluid Leak / therapy*
  • Cervical Vertebrae
  • Dura Mater* / diagnostic imaging
  • Headache Disorders / diagnostic imaging
  • Headache Disorders / etiology
  • Headache Disorders / therapy*
  • Humans
  • Intracranial Hypotension / diagnostic imaging
  • Intracranial Hypotension / etiology
  • Intracranial Hypotension / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Tarlov Cysts / complications*
  • Tarlov Cysts / diagnostic imaging
  • Tomography, X-Ray Computed
  • Treatment Outcome