Intracranial hypertension following epidural blood patch

An epidural blood patch (EBP) is the standard treatment of postural headache resulting from a spontaneous or post–lumbar puncture–induced dural tear with persistent leakage of CSF into the epidural space.1 The EBP procedure is widely thought to be safe because of the development of methods that are believed to reliably identify the epidural space, thus avoiding potentially serious complications that could occur with a deeper, subarachnoid injection. Consistent with this belief is the history of minor complications, including transient neck stiffness, tinnitus, vertigo, lower extremity paresthesias, backache, and abdominal cramps, that have been reported.2,3⇓ The perceived lack of risk was bolstered by the demonstration that a 2 mL injection of blood into the subarachnoid …