Case Report of a Rare but Serious Complication in Anesthesia: Arachnoiditis Following an Epidural Blood Patch

TL;DR

A rare complication called arachnoiditis occurred after a patient received two epidural blood patches to treat a spinal fluid leak during childbirth.

Contribution

This paper reports a rare case of arachnoiditis following epidural blood patches in a young parturient.

Findings

Arachnoiditis was diagnosed in a patient after two epidural blood patches for intracranial hypotension.

Neurological symptoms and MRI confirmed the complication.

The case highlights the need for monitoring and treatment options for spinal arachnoiditis.

Abstract

The epidural blood patch (EBP) is an invasive technique used to plug a leak of cerebrospinal fluid, usually following an iatrogenic lesion of the dura mater. This injection of autologous blood into the epidural space is associated with a number of rare but potentially serious complications. We present a case of arachnoiditis in a young parturient who presented with symptoms compatible with intracranial hypotension due to an accidental dural puncture during an obstetric epidural, and who was treated with two epidural blood patches. The diagnosis of arachnoiditis was suspected based on the neurological symptoms and confirmed by magnetic resonance imaging (MRI) of the lumbosacral region. Monitoring after an EBP and potential treatment options for spinal arachnoiditis are a current topic of discussion in anesthesia.

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