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Fluoroscopy-Guided Prophylactic Epidural Blood Patch After Lumbar Puncture in a Patient With a History of Post-Dural
Omar I Alnatour1, Billy K Huh2
1Department of Anesthesiology, McGovern Medical School, Houston, TX.
Background:
Epidural blood patch (EBP) is a known gold standard in the treatment of post-dural puncture headache (PDPH). However, there are no known reports in the literature to date that discuss a fluoroscopy-guided single-shot approach of EBP administration immediately following a lumbar puncture (LP).
Case Report:
The patient is a 71-year-old man with progressive multifocal leukoencephalopathy that presented with a history of debilitating PDPH following recurrent LPs that were required for lab monitoring. The patient underwent a single-shot LP followed by an EBP via the same needle prior to removal from the skin. The patient was free of any PDPH symptoms immediately postprocedure and on follow-up.
Conclusions:
A single-shot fluoroscopy-guided approach of administering an EBP immediately after an LP, but prior to needle removal from the skin, may be a safe and efficient approach for preventing PDPH in applicable patient populations.
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