RT Journal Article
SR Electronic
T1 Catheter-guided multilevel epidural blood patches in an adolescent boy
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 430
OP 433
DO 10.1136/rapm-2022-103487
VO 47
IS 7
A1 Walfish, Laurel
A1 Alobaikan, Sultan
A1 Lahijanian, Zubin
A1 Saint-Martin, Christine
A1 Cortes Nino, Maria delPilar
A1 Ingelmo, Pablo Mauricio
YR 2022
UL http://rapm.bmj.com/content/47/7/430.abstract
AB Background There is increasing evidence for the use of multilevel epidural catheter-guided blood patches to treat spontaneous cerebrospinal fluid leaks in adults. Yet, there are scarce data for their use in children. Furthermore, higher level epidural blood patches are uncommon in both adult and pediatric populations.Case presentation An adolescent boy with multilevel cerebrospinal fluid leaks associated with status migrainosus failed conservative pain management treatment. As he remained severely symptomatic, epidural blood patches were required to mitigate his symptoms. Given his multilevel leaks, a catheter-guided blood patch approach was used to treat multiple cervicothoracic and thoracolumbar leaks. After three separate uneventful blood patch procedures, the patient was free of symptoms. Other than some rebound intracranial hypertension, the patient maintained full neurological capacity without further complications. Following the resolution of treatment, he has not sought help for pain since his last blood patch over a year ago.Conclusions Multilevel catheter-guided blood patches have the potential to be administered to higher level spinal regions to the pediatric population suffering from multiple spontaneous cerebrospinal fluid leaks.