HomeAnswersAnesthesiologylumbar punctureAfter the blood patch, I developed swelling and a bump. Why?
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I have a pain near the tailbone after a blood patch was performed. Please help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Vansh Priya

Medically reviewed by

iCliniq medical review team

Published At August 15, 2017
Reviewed AtFebruary 11, 2024

Patient's Query

Hello doctor,

I had a spinal tap done two weeks ago, and a blood patch three days later. The blood patch worked but, I still get headaches and do not feel well at all. I have a swollen bump on my tailbone that hurts. I saw my doctor who did not seem too sure about it but, said there did not seem to be any fluid. I do not know if this is normal and do not want to go back to the hospital for no reason. I am on Tylenol extra strength.

Answered by Dr. Vansh Priya

Hello,

Welcome to icliniq.com.

You most probably experienced a post dural puncture headache (PDPH), for which you were administered an epidural blood patch.

  • Your signs and symptoms are more suggestive of a meningeal irritation due to some infection. I would suggest you consult a neurophysician for the same.
  • Meanwhile, you can do the following:
  1. Continue with Tylenol (Paracetamol).
  2. Take plenty of fluids. Drinks rich in caffeine might be of some help if it is PDPH.
  3. Get the site of spinal tap examined for redness and tenderness.

For more information consult an anesthesiologist online --> https://icliniq.com./ask-a-doctor-online/anesthesiologist

Patient's Query

Thank you doctor,

Yes, that is what I had. They did a blood patch to stop the headache. After the blood patch is when I developed the swelling. My blood work was normal. They said it could have been a bad virus such as viral meningitis. I felt that I may have irritated it yesterday and have had had a headache since. It was nothing compared to the post dural headache though. My question is since all of my tests were normal, do you think it is going to take a while to recover from the spinal tap, blood patch, and virus? Have you seen swelling at the tailbone after a blood patch in your practice?

Answered by Dr. Vansh Priya

Hello,

Welcome back to icliniq.com.

  • You are experiencing two concomitant conditions associated with the worst possible headache. If performed by experienced hands, there should be no such swelling and I personally have not seen any swelling after an epidural blood patch.
  • Was the blood patch performed by an anesthesiologist? The blood patch is supposed to relieve pain and not the other way round.
  • Regarding the headache, if it is PDPH, it is self-limiting and resolves in a week's time.
  • Did you have a fever at any point of time or during the blood patch? Was CT brain done after the blood patch?

Revert with more information to an anesthesiologist online --> https://icliniq.com./ask-a-doctor-online/anesthesiologist

Patient's Query

Hello doctor,

Thanks for replying. The procedure was done by an anesthesiologist at a reputable hospital. It helped the spinal headache right away. Before the patch, I could not stand up without throwing up. I noticed the swelling a few days after. It is below the injection site on my tailbone. I never had a fever. A CT scan of the brain was done after the spinal tap but, not after the blood patch. I saw a neurologist after the blood patch. They did not do a CT scan but, said that I seemed to be okay. My worry is that I irritated the blood patch. My regular doctor looked at the swelling and said it does not seem to look infected but, she did not seem too familiar with spinal taps and blood patches. I am worried about the swelling.

Answered by Dr. Vansh Priya

Hello,

Welcome to icliniq.com.

  • As I mentioned, a blood patch ideally should not cause a swelling.  The blood drawn from your body is injected into your epidural space, which clots there and plugs the hole in the dura mater and simply cannot make its way back to the skin. It does not dislodge at all, that too after 10 days.
  • I would advise you to consult your treating anesthetist and neurologist. Get the site examined by them. You might require a repeat CT scan and may be another epidural blood patch.

For further queries consult an anesthesiologist online --> https://icliniq.com./ask-a-doctor-online/anesthesiologist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vansh Priya
Dr. Vansh Priya

Anesthesiology

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tail bone painspinal anesthesiameningitiscsftylenolct scan of braintail bonelumbar puncturespinal tapepidural blood patchpost spinal headache

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