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Cervical Foraminal Epidural Blood Patch for the Targeted Treatment of Refractory Cerebrospinal Fluid Leakage From a Dural Sleeve
  1. Nuj Tontisirin, MD*,
  2. Pannawit Benjhawaleemas, MD,
  3. Sasikaan Nimmaanrat, MD,
  4. Pornchai Sathirapanya, MD,
  5. Teeranan Laohawiriyakamol, MD§,
  6. De Q. Tran, MD, FRCPC and
  7. Roderick J. Finlayson, MD, FRCPC
  1. *Department of Anesthesiology, Faculty of Medicine, Mahidol University, Bangkok
  2. Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  3. Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  4. §Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  5. Department of Anesthesia, Alan Edwards Pain Management Unit, McGill University, Montreal, Quebec, Canada
  1. Address correspondence to: Roderick J. Finlayson, MD, FRCPC, Department of Anesthesia, Montreal General Hospital, 1650 Ave Cedar, D10-144, Montreal, Quebec, Canada H3G 1A4 (e-mail: roderick.finlayson{at}


Abstract Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen.

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  • The authors declare no conflict of interest.