What is it about?
The effects of large-volume epidural blood patch (EBP) remain unclear in a degree of consecutive cases with cerebrospinal fluid (CSF) leaks. The procedure of large-volume EBPs using an intravenous catheter from a single lumbar entry point for the safe and appropriate administration and its outcomes in other five patients before the present series, were previously published by us (2012) in the Journal of Neurosurgery. In the present study, we report excellent outcomes from consecutive 15 CSF leak cases that underwent large-volume EBPs, together with outcomes from 4 patients who underwent direct surgical closure or simple drip-and-rest therapy at the same period. Of note, we could control this disorder almost perfectly with our clinical strategy and EBP method.
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Why is it important?
The volume of autologous blood necessary for spinal epidural space infusion in patients with CSF leak is controversial. A study reports that a conventional targeted EBP with mean autologous blood infusion volume of about 10 mL at CSF leak like points resolved headaches. In contrast, another study reports that large-volume EBP with mean autologous blood infusion volume of 40-50 mL, similar to our report, alleviated headaches.
Perspectives
we demonstrate here a perfect control of this disorder with the use of large-volume EBP through an intravenous catheter inserted into the appropriate spinal epidural space, along with adequate diagnosis and therapy.
Tatsuya Ohtonari
Brain Attack Center, Ota Memorial Hospital
Read the Original
This page is a summary of: Excellent Outcomes of Large-Volume Epidural Blood Patch Using an Intravenous Catheter in 15 Consecutive Cases with Cerebrospinal Fluid Leak, World Neurosurgery, October 2018, Elsevier,
DOI: 10.1016/j.wneu.2018.06.171.
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