• Pain Pract · Sep 2017

    Case Reports

    Successful Treatment of Post-Dural Puncture Headache Using Epidural Fibrin Glue Patch after Persistent Failure of Epidural Blood Patches.

    • Kevin Wong and Brian R Monroe.
    • Division of Anesthesiology, Geisinger Medical Center, Danville, PA, U.S.A.
    • Pain Pract. 2017 Sep 1; 17 (7): 956-960.

    ObjectivesEpidural blood patch is the gold standard for the treatment of postdural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH.Case ReportThis case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial. She was successfully treated with epidural fibrin glue patch after multiple trials of epidural blood patches.ConclusionPercutaneous injection of fibrin glue to seal the dural defect demonstrated promising outcomes for both immediate and long-lasting resolution of persistent PDPH in our patient. In the event of epidural blood patch failure, epidural fibrin glue patch may be a reasonable alternative for the treatment of persistent PDPH.© 2016 World Institute of Pain.

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