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Abstract

1. 2023;7;69-72 Management of Persistent Cerebrospinal Fluid Leak With an Epidural Blood Patch Following Removal of Lumbar Drain and Failed Neurosurgical Intervention: Case Report
   Case Report
   Leah Tharian , Antony R. Tharian, MD, and Nebojsa Nick Knezevic, MD, PhD.

BACKGROUND: Persistent cerebrospinal fluid (CSF) leak is a complication of a dural puncture that can be idiopathic, traumatic, or iatrogenic in nature.

CASE REPORT: We present a case of a 43-year-old woman, diagnosed with a spontaneous CSF rhinorrhea that was treated with temporary placement of a lumbar drain. Upon discharge, the patient experienced a persistent CSF leak from the lumbar drain site, as well as a positional headache and vertigo that persisted even after application of reinforcement sutures at the lumbar drain site by the neurosurgery team. The patient was subsequently treated with an epidural blood patch (EBP) at L3-L4 interspace with autologous venous blood injected into the epidural space. During the follow-up 2 weeks after the intervention, there was a complete resolution of her symptoms, as well as the CSF leakage.

CONCLUSIONS: A CSF leak after lumbar drain removal that persists even after neurosurgical intervention can be successfully treated with an EBP.

KEY WORDS: CSF leak, rhinorrhea, epidural blood patch, lumbar drain, case report

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