Subarachnoideal blood spread following epidural blood patch given to treat spontaneous intracranial hypotension: Can it cause neurological complications?

•Epidural blood patch (EBP) was used to treat spontaneous intracranial hypotension.•Over a 20-year period, 106 patients were treated with EBP.•Subarachnoideal blood spread following EBP was observed in 8.5% of patients.•No neurological complications or changes in treatment efficacy were observed.

Objective(1) To determine the frequency of subarachnoid blood spread following epidural blood patch (EBP) in a cohort of subjects with spontaneous intracranial hypotension (SIH). (2) To describe the outcome of these patients.Patients and methodsIn a cohort of 106 patients exhibiting SIH, spiral spinal CT scans were obtained post-lumbar EBP and neuroradiological data was reviewed for evidence of subarachnoideal bleeding.ResultsSubarachnoideal blood spread was detected on spinal CT scans following EBP in 9 of 106 patients with SIH. All patients exhibited a complete recovery and no neurological complications were observed.ConclusionsA low incidence of subarachnoideal blood spread was observed following EBP given to treat SIH. Instances of subarachnoideal blood spread were not associated with neurological complications or altered efficacy of the EBP procedure.