[Epidural injection of autologous blood for postlumbar-puncture headache].

The most frequent complication of lumbar puncture is headache. It is due to lowered intracranial tension produced by a continued leakage of cerebrospinal fluid (CSF) through the dural puncture site. Epidural injection of autologous blood has been frequently reported as highly effective in the treatment of lumbar-puncture-induced headache, with success rates of 73 to 98%. To our knowledge, in Yugoslavia there has been, so far, no report, concerning the use of this techique. The aim of this study is to evaluate the treatment of postlumbar-puncture headache by epidural blood patch in our 20 patients. Here we also describe one patient with severe headache induced by lumbar puncture, in whom we documented the CSF pressure less than atmospheric. Criteria for selection into the study included: subjective evaluation of the extent of headache and accompanying symptoms, duration of symptoms more than 48 hours, and failure of headache relief with conservative measures. We injected 3-5 ml of aseptically obtained autologous blood at the site of suspected dural puncture. When evaluated an hour after treatment, all patients experienced complete relief. In only one (5%) of 20 treated patients, headache reccurred after initial relief. We have not observed any side-effects in our patients. Our results are in harmony with the published high efficiencies of autologous epidural blood patch in the treatment of postlumbar-puncture headache. We recommend the injection of 5 ml of autologous blood in the epidural space in all patients with severe lumbar-puncture-induced headache, resistant to conservative therapy, lasting more than 24-48 hours.