Complications following large-volume epidural blood patches for postdural puncture headache. Lumbar subdural hematoma and arachnoiditis: initial cause or final effect?
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.
Riley
Cara A
CA
Department of Anesthesiology, Critical Care, and Pain Management, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
Spiegel
Joan E
JE
D000328:Adult; D001100:Arachnoiditis / Q000209:etiology; D017217:Blood Patch, Epidural / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D046649:Hematoma, Subdural, Spinal / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D051299:Post-Dural Puncture Headache / Q000628:therapy*; D011247:Pregnancy; D011843:Radiculopathy / Q000209:etiology; D012447:Sacrum / Q000473:pathology; D013129:Spinal Puncture / Q000009:adverse effects