Use of epidural blood patch in treating chronic headache: report of six cases.

Chronic headaches are difficult problems to manage effectively. A select group of six patients with headache symptoms (throbbing headaches, located in the frontal or occipital areas; aggravated by ambulation and relieved by recumbency) resembling post-dural puncture headache received epidural blood patches using autologous blood for their chronic headaches. Five of the six patients obtained effective and sustained pain relief. All of the patients had received placebo injections with normal saline in the paraspinous muscles, without effect. The mechanism of action of the blood patch in these patients is unclear. It is possible that the headache may have been caused by a low pressure cerebrospinal fluid state, due to an unknown anatomical or physiological defect of the ventriculo-spinal system. Further studies are needed to evaluate this treatment modality.