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Anesthesiology Research and Practice
Volume 2012, Article ID 923904, 4 pages
http://dx.doi.org/10.1155/2012/923904
Review Article

Transforaminal Blood Patch for the Treatment of Chronic Headache from Intracranial Hypotension: A Case Report and Review

1Department of Anesthesiology and Pain Management, University of Arizona, 1501 N. Campbell Avenue, Room 5301, P.O. Box 245114, Tucson, AZ 85724, USA
2Department of Pharmacology, University of Arizona, Tucson, AZ 85724, USA
3Department of Neurology, University of Arizona, Tucson, AZ 85724, USA
4El Paso Orthopaedic Surgery Group, El Paso, TX 79930, USA

Received 8 April 2011; Accepted 16 June 2011

Academic Editor: Andrea Trescot

Copyright © 2012 Kirk Bowden et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This case report describes the successful treatment of chronic headache from intracranial hypotension with bilateral transforaminal (TF) lumbar epidural blood patches (EBPs). The patient is a 65-year-old male with chronic postural headaches. He had not had a headache-free day in more than 13 years. Conservative treatment and several interlaminar epidural blood patches were previously unsuccessful. A transforaminal EBP was performed under fluoroscopic guidance. Resolution of the headache occurred within 5 minutes of the procedure. After three months without a headache the patient had a return of the postural headache. A second transforaminal EBP was performed again with almost immediate resolution. The patient remains headache-free almost six months from the time of first TF blood patch. This is the first published report of the use of transforaminal epidural blood patches for the successful treatment of a headache lasting longer than 3 months.