Percutaneous CT-guided epidural fibrin sealant injection for refractory pediatric post-dural puncture headache.

James M Roberts, Victoria E Peterson, Manraj K S Heran

Pediatric radiology 2020 Jul

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Post-dural puncture headache is an uncommon entity in young children and adolescents. Percutaneous epidural blood patching has been classically used to manage refractory post-dural puncture headaches. Injectable fibrin sealant has been shown in a few adult cases to relieve symptoms where blood patching has either failed or was not appropriate. We report a 10-year-old boy who experienced rapid relief of post-dural puncture headache symptoms following percutaneous lumbar epidural fibrin sealant injection under computed tomography guidance. Percutaneous epidural fibrin sealant injection may be an acceptable treatment for post-dural puncture headaches refractory to epidural blood patching, or when an epidural blood patch is otherwise contraindicated. The pediatric interventional radiologist should be aware of this off-label use of fibrin sealant.

Citation

James M Roberts, Victoria E Peterson, Manraj K S Heran. Percutaneous CT-guided epidural fibrin sealant injection for refractory pediatric post-dural puncture headache. Pediatric radiology. 2020 Jul;50(8):1156-1158