[Blood-patch treatment of headache occurring after post-dural puncture at the thoracic level]

A 23-year-old woman experienced headache following a high thoracic epidural analgesia to control postoperative pain after thoracoscopic treatment of a recurrent pneumothorax. On fourth postoperative day, a blood patch has been sited with 17 mL of autologous blood, injected into the thoracic epidural space at T1-T2 level, which was immediately effective. Except a mild and transient cervical pain during the procedure, no other complication occurred. The technique of thoracic blood patch is similar to the lumbar one, except some minor modifications. According to this case of a thoracic epidural blood patch which is seemingly the first one reported in the literature and our expertise with two other unpublished cases, a volume of 10 mL of blood may be sufficient and free of adverse effects.