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Chronic adhesive arachnoiditis after repeat epidural blood patch.

C Carlswärd¹, B Darvish², J Tunelli³

¹Department of Anesthesiology, Capio St Görans Hospital, Stockholm, Sweden.

International Journal of Obstetric Anesthesia

|June 30, 2015

Summary

This summary is machine-generated.

Repeat epidural blood patching for postdural puncture headache can lead to rare but disabling chronic adhesive arachnoiditis. This case highlights the need for caution with repeat procedures in parturients.

Keywords:

Arachnoiditis Epidural blood patch Postdural puncture headache

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Area of Science:

Neurology
Anesthesiology
Neurosurgery

Background:

Epidural blood patching (EBP) is a standard treatment for postdural puncture headache (PDPH).
While effective, EBP carries potential risks, including the rare complication of arachnoiditis.

Observation:

A case of chronic adhesive arachnoiditis developed in a parturient following a repeat EBP for PDPH.
The patient experienced severe neurological symptoms, confirmed by MRI, two years post-procedure.

Findings:

Repeat EBP in a parturient led to severe, unresolved neurological deficits consistent with chronic adhesive arachnoiditis.
Magnetic resonance imaging confirmed arachnoiditis as the cause of the patient's persistent symptoms.

Implications:

This case underscores the critical need for caution when considering repeat EBPs for PDPH in obstetric patients.
Awareness of this rare but severe complication is essential for patient safety and informed consent in anesthesiology.
Further research into risk factors and alternative treatments for refractory PDPH may be warranted.