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Anesthesiol Res Pract. 2012; 2012: 923904.
Published online Jul 18, 2011. doi:  10.1155/2012/923904
PMCID: PMC3139890
Transforaminal Blood Patch for the Treatment of Chronic Headache from Intracranial Hypotension: A Case Report and Review
Kirk Bowden, 1 Adam Wuollet, 1 Amol Patwardhan, 1 Theodore J. Price, 2 John Lawall, 3 Jeffery Annabi, 4 Steven Barker, 1 and Emil Annabi 1 *
1Department of Anesthesiology and Pain Management, University of Arizona, 1501 N. Campbell Avenue, Room 5301, P.O. Box 245114, Tucson, AZ 85724, USA
2Department of Pharmacology, University of Arizona, Tucson, AZ 85724, USA
3Department of Neurology, University of Arizona, Tucson, AZ 85724, USA
4El Paso Orthopaedic Surgery Group, El Paso, TX 79930, USA
*Emil Annabi: eannabi/at/
Academic Editor: Andrea Trescot
Received April 8, 2011; Accepted June 16, 2011.
This case report describes the successful treatment of chronic headache from intracranial hypotension with bilateral transforaminal (TF) lumbar epidural blood patches (EBPs). The patient is a 65-year-old male with chronic postural headaches. He had not had a headache-free day in more than 13 years. Conservative treatment and several interlaminar epidural blood patches were previously unsuccessful. A transforaminal EBP was performed under fluoroscopic guidance. Resolution of the headache occurred within 5 minutes of the procedure. After three months without a headache the patient had a return of the postural headache. A second transforaminal EBP was performed again with almost immediate resolution. The patient remains headache-free almost six months from the time of first TF blood patch. This is the first published report of the use of transforaminal epidural blood patches for the successful treatment of a headache lasting longer than 3 months.
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