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Anesthesia

Spinal Fluid Leak

09/03/2010

Question:

I had cortizone epidural 2 weeks ago I got a spinal headache with vomiting, got blood patch last week and it didn`t work. I can`t get up from flat position without almost passing out and vomiting. I am supposed to have another blood patch tomorrow. What do the doctors do if it doesn`t work?

Answer:

A blood patch usually helps a spinal headache but not 100% of the time. If the diagnosis is certain it can be worth trying again. Although this is a very unpleasant complication it is not life- threatening and will resolve (get better) over time.

If the second blood patch does not work your doctors will want to make sure they have the right diagnosis, based on taking a careful history and doing a good physical examination. Sophisticated tests aren't usually necessary unless there are features not typical of a spinal headache. The postural symptoms you describe are typical of a spinal headache.

Your doctors might advise simply waiting it out and taking pain killers, caffeine, and staying hydrated. Hope it works!

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University