Epidural blood patch for the treatment of liquor hypotension after intrathecal chemotherapy in a 10-year-old: case report

Abstract

Background and objectives: An epidural blood patch is used to treat postdural puncture and liquor hypotension headache. We report the use of an epidural blood patch in a critical pediatric patient. Case report: A 10-year-old girl with acute leukemia developed venous cerebral thrombosis with hemorrhagic transformation one month after intrathecal chemotherapy. Given the unusual clinical and imagiological evolution even after decompressive craniectomy, we suspected cerebrospinal fluid hypotension. Spine imaging revealed signs of post-lumbar puncture fistula; we hence performed a blind blood patch. Conclusions: Recognizing cerebrospinal fluid hypotension in critical pediatric patients is important. Less-conventional life-saving measures, such as a blind blood patch, may be considered in such patients.

Keywords

• Blood patch, epidural
• Chemotherapy
• Intracranial hypotension
• Cerebrospinal fluid leak