title: Subarachnoideal blood spread following epidural blood patch given to treat spontaneous intracranial hypotension: Can it cause neurological complications?
abstract: OBJECTIVE
  (1) To determine the frequency of subarachnoid blood spread following epidural blood patch (EBP) in a cohort of subjects with spontaneous intracranial hypotension (SIH). (2) To describe the outcome of these patients.
  
  
  METHODS
  In a cohort of 106 patients exhibiting SIH, spiral spinal CT scans were obtained post-lumbar EBP and neuroradiological data was reviewed for evidence of subarachnoideal bleeding.
  
  
  RESULTS
  Subarachnoideal blood spread was detected on spinal CT scans following EBP in 9 of 106 patients with SIH. All patients exhibited a complete recovery and no neurological complications were observed.
  
  
  CONCLUSIONS
  A low incidence of subarachnoideal blood spread was observed following EBP given to treat SIH. Instances of subarachnoideal blood spread were not associated with neurological complications or altered efficacy of the EBP procedure.
authors.affiliation: Headache Centre, Department of Neurological Science, Azienda Ospedaliera Niguarda Ca' Granda, Milano, Italy. Electronic address: enricoferrante@libero.it.
authors.forename: E
authors.initials: E
authors.lastname: Ferrante
authors.affiliation: 1st Unit of Anaesthesia and Intensive Care, Azienda Ospedaliera Niguarda Ca' Granda, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rubino
authors.affiliation: School of Specialization in Anaesthesiology and Intensive Care, University of Milan-Bicocca, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mongelli
authors.affiliation: 1st Unit of Anaesthesia and Intensive Care, Azienda Ospedaliera Niguarda Ca' Granda, Milano, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Arpino
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural / Q000379:methods; D001921:Brain / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006261:Headache / Q000209:etiology / Q000601:surgery*; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Epidural blood patch; Headache; Spontaneous intracranial hypotension; Subarachnoideal blood