Epidural blood patch for the treatment of chronic headache after myelography

Isotope studies have related chronic headache after myelography to persistent leakage of normal cerebrospinal fluid (CSF) through an unsealed puncture hole in the dura and arachnoid. Although a technique well known to anesthesiologists, the use of an epidural blood patch (EBP) as a means to seal the dural opening is not known to many radiologists. We have used this technique successfully in three patients and believe it should be performed on all those still suffering from typical postural headaches three weeks after myelography if conservative treatment has failed and if there are no contraindications.