Epidural Blood Patch (EBP)
Specialist treatment for Post-Dural Puncture Headache (PDPH) after labor epidural or lumbar puncture, and spontaneous intracranial hypotension.
Understanding the Epidural Blood Patch
Low pressure headaches occur when cerebrospinal fluid (CSF) leaks through a hole in the tough membrane surrounding the brain and spinal cord, often following a lumbar puncture or occurring spontaneously. This loss of fluid reduces the buoyancy of the brain, causing it to sag when you are in an upright position.
The result is a severe, debilitating headache that typically worsens when standing and improves when lying down, often accompanied by neck stiffness, nausea, and hearing changes.
An Epidural Blood Patch (EBP) is a highly effective procedure designed to resolve these symptoms by patching up the leak and restoring intracranial (brain) pressure. In this procedure, an interventional pain physician will carefully inject your own blood into the epidural space near the site of the leak. The blood forms a natural seal over the hole, preventing further fluid loss and allowing the intracranial pressure to normalize.
Patient FAQs
Most patients notice a clear improvement in their headache within a few hours of an epidural blood patch. You will usually be asked to lie flat for a short period after the procedure and to avoid heavy lifting or strenuous activity. Mild back soreness at the injection site is common and usually settles within a few days. If your symptoms return or do not improve, a repeat assessment and, in some cases, a second blood patch may be needed.
Epidural blood patch is a very well tolerated procedure. It is usually performed under local anaesthesia. During the injection of blood into the epidural space, you may experience some back, leg pain or headache. Your doctor will constantly monitor you for these symptoms.
It is common to experience some back pain for a few days up to a week, following this procedure. This pain is usually mild and responds well to simple painkillers, which your doctor will prescribe for you.
An epidural blood patch can be performed either with or without image guidance. However, we advocate the use of image guidance to improve accuracy and safety. Using fluoroscopy (live X-ray) or CT guidance allows your specialist to clearly visualise the spine, confirm the correct level, and ensure that the blood is delivered precisely into the epidural space. This reduces the risk of a failed patch, minimises complications, and is especially important in patients with previous spinal surgery, scoliosis, or technically difficult anatomy.
Epidural blood patch is generally a safe and well‑tolerated procedure, but like all medical procedures it carries some risks. The more common side effects include temporary back soreness at the injection site, a feeling of pressure in the lower back or legs during the injection, and mild bruising. Less commonly, patients may experience a temporary increase in headache, a repeat dural puncture, or infection or bleeding around the spine. Serious complications are rare, especially when the procedure is performed by an experienced specialist using sterile technique and image guidance.
Many patients experience a noticeable improvement in their headache within a few hours of an epidural blood patch, and some feel relief almost immediately. In others, the benefit may build gradually over the first 24 hours as the blood clot seals the leak and the cerebrospinal fluid pressure normalises. A small number of patients may have only partial relief or no improvement after the first patch and may require reassessment and, in some cases, a second procedure. Your specialist will discuss what to expect in your specific situation.
Specialist Assessment with Dr Christopher Liu
Dr Christopher Liu is a dedicated pain and headache specialist in Singapore. He provides comprehensive assessments for patients suffering from persistent symptoms such as PDPH and spontaneous intracranial hypotension. If appropriate, he offers expertly performed epidural blood patch treatments to help you find relief.
For specialist advice on epidural blood patch treatment, contact us directly at +65 86555722.