Author: Gomez M, et al.
Journal of Neurosurgical Anesthesiology 37(3):271-278, July 2025. doi:10.1097/ANA.0000000000000981
This case series evaluated the effectiveness of epidural blood patch (EBP) in treating spontaneous intracranial hypotension (SIH). Data from 36 patients at a single Canadian center (2010–2022) were analyzed, encompassing 82 EBP procedures. Clinical details, treatment techniques, and outcomes were reviewed, with univariate analysis used to explore predictors of efficacy.
EBP provided immediate symptomatic relief for nearly all patients, but durability varied. At one month, efficacy improved with increasing number of attempts (P = 0.032). However, neither technique type nor injectate volume was linked to superior outcomes. Permanent resolution occurred in only 29% of EBPs overall, but 67% of patients achieved long-term resolution after repeated procedures. Tailored approaches—such as targeted higher-volume EBPs or catheter-guided multi-level injections—showed promise in refractory cases.
Key Takeaways
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EBPs provided immediate but sometimes temporary relief in SIH patients.
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One-month success rates improved with repeated EBPs.
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No single technique or injectate volume predicted better outcomes.
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Permanent resolution was achieved in 67% of patients after multiple EBPs.
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Targeted, higher-volume, or multi-level catheter-guided EBPs may improve results in refractory cases.
Thank you to the Journal of Neurosurgical Anesthesiology for publishing this important contribution on the evolving role of EBPs in spontaneous intracranial hypotension.