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An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
A small amount of the person's blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. EBP is effective, [17] and further intervention is rarely necessary. 25–35% of patients suffer from transient back pain after EBP. [18]
Epidural administrations can also cause bleeding issues, including "bloody tap", which occurs in approximately 1 in 30–50 people. [27] This occurs when epidural veins are inadvertently punctured with the needle during the insertion. It is a common occurrence and is not usually considered a problem in people who have normal blood clotting.
Once identified, the leak can often be repaired by an epidural blood patch, an injection of the patient's own blood at the site of the leak, a fibrin glue injection, or surgery. A spontaneous CSF leak is a rare condition, affecting at least one in 20,000 people and many more who go undiagnosed every year.
More likely after major operations than minor operations. [9] [11] More likely after heart operations than other types of surgery. [9] [11] More likely in aged than in younger patients. [9] [11] More likely in older patients with high alcohol intake. [12] People with higher preoperative ASA physical status scores are more likely to develop POCD ...
The risk of headache and need for analgesia and blood patch is much reduced if "atraumatic" needles are used. This does not affect the success rate of the procedure in other ways. [ 18 ] [ 19 ] Although the cost and difficulty are similar, adoption remains low, at only 16% c. 2014 .
A subdural hygroma (SDG) is a collection of cerebrospinal fluid (CSF), without blood, located under the dural membrane of the brain. Most subdural hygromas are believed to be derived from chronic subdural hematomas. They are commonly seen in elderly people after minor trauma but can also be seen in children following infection or trauma.
Geriatric trauma refers to a traumatic injury that occurs to an elderly person. People around the world are living longer than ever. In developed and underdeveloped countries, the pace of population aging is increasing. By 2050, the world's population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015. [1]