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Epidural blood patch: A narrative review.
Paul J Zetlaoui1, Thomas Buchheit2, Dan Benhamou3
1Université Paris Saclay, AP-HP, Hôpital Bicêtre, Service d'Anesthésie Réanimation Médecine Péri Opératoire - 78, rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.
Anaesthesia, Critical Care & Pain Medicine
|August 11, 2022
Summary
The epidural blood patch (EBP) effectively treats intracranial hypotension, including spontaneous cases. This review covers EBP procedures, indications, and novel evaluation methods for improved patient outcomes.
Area of Science:
- Neurology
- Anesthesiology
- Neurosurgery
Background:
- Intracranial hypotension (IH) can result from dural puncture or spontaneous causes.
- The epidural blood patch (EBP) is a primary treatment for IH.
- Non-iatrogenic IH presents unique therapeutic challenges.
Purpose of the Study:
- To provide a narrative review of epidural blood patch (EBP) for intracranial hypotension (IH).
- To discuss procedural and diagnostic considerations for various IH presentations.
- To aid clinicians in tailoring EBP treatment, especially in diagnostic dilemmas.
Main Methods:
- Review of EBP history, anatomy, and mechanisms of action.
- Examination of clinical indications, contraindications, and complications.
- Presentation of objective evaluation methods like MRI and Doppler ultrasound.
Main Results:
- EBP is highly effective for iatrogenic IH and increasingly used for spontaneous IH.
- Non-iatrogenic IH requires careful consideration of diagnostic and procedural aspects.
- Novel objective methods can enhance diagnostic accuracy and treatment success.
Conclusions:
- EBP is a cornerstone treatment for IH, requiring tailored approaches for spontaneous cases.
- Understanding EBP nuances is crucial for effective patient management.
- Advanced imaging and ultrasound offer promising avenues for evaluating EBP efficacy.
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