Epidural Blood Patches
• Typically performed with CT fluoroscopy but can be done fluoroscopically guided
• Most common indications:
• Post dural puncture headache
• Spontaneous intracranial hypotension
Epidural Blood Patches - Steps
1. Determine site for blood patch
2. Position patient prone and obtain planning scan
3. Mark, prep and drape patient
4. Obtain epidural access (interlaminar or transforaminal)
5. Obtain blood (amount determined by attending)
6. Inject blood while obtaining patient feedback and periodically imaging
Epidural Blood Patches
• If interlaminar approach, use loss of resistance technique to get epidural access
• For CSF leaks, may use fibrin glue / Tisseel in addition to blood. This is determined by the attending prior to the procedure.
