Background: Epidural blood patch (EBP) is a known gold standard in the treatment of post-dural puncture headache (PDPH). However, there are no known reports in the literature to date that discuss a fluoroscopy-guided single-shot approach of EBP administration immediately following a lumbar puncture (LP).

Case Report: The patient is a 71-year-old man with progressive multifocal leukoencephalopathy that presented with a history of debilitating PDPH following recurrent LPs that were required for lab monitoring. The patient underwent a single-shot LP followed by an EBP via the same needle prior to removal from the skin. The patient was free of any PDPH symptoms immediately postprocedure and on follow-up.

Conclusions: A single-shot fluoroscopy-guided approach of administering an EBP immediately after an LP, but prior to needle removal from the skin, may be a safe and efficient approach for preventing PDPH in applicable patient populations.

KEYWORDS: Post-dural puncture headache, case report, epidural blood patch, fluoroscopy, lumbar puncture