Sanders John C, Gandhoke Ronnie, Moro Michele
Department of Pediatric Anesthesiology, University of New Mexico, Albuquerque, New Mexico.
Anesth Analg. 2004 Mar;98(3):629-31, table of contents. doi: 10.1213/01.ane.0000100661.31566.43.
A 3-yr-old with B-cell lymphoma presented with a 5-wk history of 400 mL/day cerebrospinal fluid (CSF) leak, which precluded chemotherapy, after placement of an Omaya reservoir and drain. Surgical repair was unsuccessful. Symptoms included irritability, failure to eat and noncommunication. After lumbar epidural blood patch with 7 mL the symptoms resolved immediately, allowing recommencement of chemotherapy. Epidural blood patch should be considered as possible early treatment for CSF leaks.
An epidural blood patch successfully treated a large cerebrospinal fluid leak of long duration in a 3-yr-old. Considering the distress of such a leak to the patient, staff, and parents, epidural blood patch may be considered as an early treatment option.