Hi, I am new to BT and I could use some guidance on blood patches. I have a spontaneous CSF leak. Iíve had a brain MRI that has the usual findings for intracranial hypotension as well as a spinal C-T myelogram and MRI that show many Tarlov cysts in all areas of my spine and a ďbaggy thecal sacĒ. The location of the leak hasnít been identified.

Iíve had 3 blood patches - one at my local hospital and the last 2 at UCSF by Dr. WIlliam Dillion. The last patch was done at T12-L1 & L2-3. All 3 patches used 20 cc of blood (3rd used 10 and 10 in the 2 places) and seem to have had about the same course - complete resolution of headache for about 24 hours, then mild-moderate headache for about 2 weeks, then a severe headache as soon as I stand up in the morning, with head movement, and after being up too long. The headaches can always be relieved with laying down. Driving or riding in a car makes them much worse.

Iím being scheduled for a 4th blood patch at UCSF soon. Does anyone have tips for for getting a patch to stick? With the last 3, Iíve stayed in the hospital for about 24 hours after the patch and it seems like the patch starts to fail about the time Iím going home, even though I try to do that as carefully as possible and stay laying down for the next 2-3 days.

Thank so much.