Complications following large-volume epidural blood patches for postdural puncture headache. Lumbar subdural hematoma and arachnoiditis: initial cause or final effect?

Abstract

Significant complications following large-volume epidural blood patches (LEBPs) in two parturients following LEBP for postdural puncture headache are reported. A 39-year-old woman developed a spinal subdural hematoma causing both lumbar back and radicular pain following a single LEBP using 58 mL of blood. The second case was a 33-year-old woman who received three LEBPs over a 4-day period totaling 165 mL of blood. She developed arachnoiditis and chronic sacral radiculopathy with resolution 4 months later.

• Authors: Cara A Riley, Joan E Spiegel
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 21 Issue 5 Pg. 355-9 (Aug 2009) ISSN: 1873-4529 [Electronic] United States
• PMID: 19700281 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Arachnoiditis (etiology)
• Blood Patch, Epidural (adverse effects)
• Female
• Follow-Up Studies
• Hematoma, Subdural, Spinal (etiology)
• Humans
• Lumbar Vertebrae (pathology)
• Post-Dural Puncture Headache (therapy)
• Pregnancy
• Radiculopathy (etiology)
• Sacrum (pathology)
• Spinal Puncture (adverse effects)