Epidural Blood Patch for Headaches after Endocopic Third Ventriculostomy.

Abstract

A case of low pressure headache after an endoscopic third ventriculostomy treated with epidural blood patch is presented in this report.The patient presented with a severe debilitating headache that interfered with his daily activities. He was evaluated with an MRI cine study that showed free flow through the ventriculostomy, and a lumbar puncture with an opening pressure of 6cmH2O.Initial treatments were narcotics, hydration and caffeine without resolution of symptoms. The patient was then seen by anesthesia and an epidural blood patch was thought to be appropriate, due to the pathophysiology of her current debilitating symptom.An uneventful epidural blood patch was done, with immediate resolution of the present symptom.Epidural blood patch may be useful in the treatment of low pressure headaches of etiologies other than secondary to lumbar or thoracic punctures.Implication Statement: Anesthesiologists are sometimes called upon to perform epidural blood patches for patients who have had a dural tear after a procedure along the spinal column. This is a case in which a lumbar epidural blood patch helped a patient who had a hole put in his third ventricle.