An epidural blood patch is a surgical procedure that provides immediate relief to the headache caused by leaking spinal fluid. Approximately 15-20 mls of blood is taken from a vein in the patient’s arm and subsequently injected into the epidural space in the spine at the site of the spinal fluid leak.

The blood clots and seals the hole in the dura (the membrane which covers the spinal cord) which stops fluid from leaking out. The procedure is used to relieve severe headaches caused when an epidural, spinal needle, or diagnostic lumbar puncture punctures a hole in the dura.

It is has also been suggested that immediate relief of headache after a blood patch is due to pressure against compression and squeezing effect against the dura which relieves the low pressure in the head.

The patient is monitored for approximately one hour and discharged shortly after. Often, relief is immediate, but it can take a day or two for symptoms to disappear completely.

If you or a family member has an epidural blood patch, it is important for a few days to try to avoid coughing, sneezing, laughing and straining anything which could dislodge the clot. Try to rest for a couple of days and give the blood patch time to let the hole in the dura knit together and heal.

Pain radiating from the patient’s back and down their legs for a couple of days after the procedure is not uncommon (and it can be very painful) and this is because blood is an irritant. There are other risks involved including the same risks as having an epidural (please read Pros and Cons of Epidurals<) plus a small chance of developing meningitis because blood can contain organisms. A blood patch is not advised in the case of a fever. However, if a csf leak is not fixed, there are also risks associated with that including subdural hematoma, blindness and brain herniation which have been reported in medical literature. Please read Epidural Headache With A Late Onset for more details.

There is a high chance of failure of epidural blood patch if it is done within 24 hours of onset of headache, success is increased markedly after 24 hours.

Also please read What Is An Epidural Headache? for further information.