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Anesthesiology/Blood Patch Complication?


QUESTION: One week after having a blood patch (for spinal HA after labor epidural), I began having strange physical symptoms. - The BP did cure the spinal headache immediately. One week following the BP, I started being lightheaded and slightly nauseous with no appetite. With these episodes, I would become "foggy"-headed for several hours at a time and shaky (as if I had several cups of coffee but didn't). These "episodes" have been happening now for about 5 weeks. I have had a brain MRI and lower spine MRI as well as blood work, which has all been "good". All hormone testing has been good as well.
Could these symptoms/episodes be a side-effect of the BP? OR is it possible that I may still have a mild CSF leak? A Dr. also mentioned the possibility of irritated meninges form the BP as well. I desperate to get well soon! Any opinions/advice for direction on this issue would be greatly appreciated!

ANSWER: Hi Candace

Sorry to hear you are having this frustrating experience.

My experience has been that issues related to the BP would come up within the first few days after the procedure. Complications related to the blood patch are often minor but rarely can be major such as a subdural hematoma, Pneumocephalus, infection etc. The tests you had would have picked these things up, specifically the MRI of the brain and lower spine. So I would doubt it is now related to the BP. I would also think if it was a slow CSF leak (which would be exceedingly rare at this point) you would continue to have symptoms like your original ones.

My suggestion at this point would be to get a neurologist consult (if you have not already). This seems like something other than the BP but there is always the possibility that you have some unusual symptoms caused by a rare complication related to the delivery.

I hope you get better soon and im really sorry this has happened to you!

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QUESTION: What are your thoughts about possible inflamed meninges after the BP? If so, wouldn't they have resolved by now?
Are there other tests you might recommend to be thorough to make sure we aren't leaving anything out?

Hi again!

I did a lit search on post epidural blood patch irritation of the meninges and could not find any case reports similar to your symptoms. Most report a triad of nuchal rigidity (neck stiffness), photophobia (intolerance of bright light) and headache. So it does not sound like what you are experiencing but then again it cannot be ruled out.

I cannot think of any additional tests you should undergo but I would suggest seeing a neurologist.

Sorry I could not find more, i hope it resolves for you soon.


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Mike MacKinnon MSN FNP-C CRNA


I am a former Trauma Flight RN now a Family Nurse Practitioner and a Nurse Anesthetist (CRNAs). I can help answer questions on the CRNA profession and clinical anesthesia. I work full time as an independent practice CRNA and have a special interest in regional anesthesia, particularly peripheral nerve blocks. I also teach ultrasound regional anesthesia and lecture all over the country. If I do not know the answer, I will find it for you.


I am a Family Nurse Practitioner and a Nurse Anesthetist who works as an independent/autonomous practitioner. There are often questions about my profession and I would like to offer the service of an actual CRNA. If you did not know, there are about 40000 of us which equates to 50% of the anesthesia providers in the USA today. I also lecture and teach ultrasound regional anesthesia all over the country.

AANA (American Association of Nurse Anesthetists)
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Air Medical Transport Journal
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Bachelors of Science in Nursing
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