Epidural blood patch for management of postdural puncture headache in adolescents

Ylönen, Paula; Kokki, Hannu

doi:10.1034/j.1399-6576.2002.460707.x

Cited by 41 publications

(47 citation statements)

References 24 publications

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“…It is possible that these patients did not get enough information concerning treatment of headache or fear of the procedure kept them home. While drugs in treatment of PDPH are usually ineffective [19], epidural blood patching is safe, fast and effective in 90% of patients; and if repeated in patients showing a poor response the response rate rises up to 98% [20][21][22][23]. Despite that, epidural blood patch is underused in the treatment of patients with diagnostic lumbar puncture.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

et al. 2005

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Post–lumbar puncture headache is a frequent clinical problem. Needle design is expected to reduce post–puncture headache. In this study, we compared two different lumbar puncture needle designs in diagnostic lumbar puncture and analysed post–dural puncture headache (PDPH) and social and economical harm associated with the diagnostic lumbar puncture procedure. This prospective, controlled study consisted of 80 consecutive adult patients requiring elective diagnostic lumbar puncture due to various neurological symptoms. Lumbar puncture was completed either with Spinocan ® 22 G sharp bevel needle or Whitacre ® 22G pencil point needle. Patients were asked about previous headache symptoms and pain provoked by puncture. One week after the lumbar puncture all patients were interviewed by telephone and occurrence and type of headache, headache intensity, medication and frequency of impairment in activities of daily living were asked. Need for epidural blood patch was also recorded. Thirty–three of 78 (42%) patients experienced headache after diagnostic lumbar puncture and in 26 (33%) the headache could be classified as PDPH. There were no statistically significant differences between needle types in the frequency of common headache, PDPH, puncture pain intensity, need for epidural blood patch or sick leave. Also, there were no other complications except local back pain or headache. In this study, the needle design did not affect the frequency of PDPH. Also, PDPH was common, occurring in 33% cases and caused a considerable amount of disturbance in daily activities. Seeking help for this condition was insufficient and only part of these PDPH patients were treated with epidural blood patch.

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Section: Discussionmentioning

confidence: 99%

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

et al. 2005

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“…Of the 40 articles to which we refer and which were published between 1990 and 2002, 9 review existing literature and refer to numerous studies but often do not mention how many patients are included in the studies [5,7,8,10,11,13,15,23,34]. Twenty-one articles are prospective studies, referring to other studies in the discussion [3,6,9,12,14,16,17,18,19,20,21,22,25,28,32,33,35,37,38,39,41]; four are retrospective studies [1,26,31,40], three are case reports followed by literature review [4,27,36]; two editorials [2,29] and one is a letter [30].…”

Section: Introductionmentioning

confidence: 97%

Post-dural puncture headaches in children. A literature review

Janssens

Aerssens²,

Alliët³

et al. 2003

Eur J Pediatr

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“…Clinical experience has shown that epidural blood patch by preventing leakage through occluding the perforation is an effective therapy to treat a persistent post-spinal headache, with a success rate of more than 90% (3,4,5,34). However, as mentioned in the Introduction, a small CSF leakage is not compatible with a marked symptomatic influence on pain-sensitive regions of the brain, and especially not with the postural properties of the post-spinal headache, or the fact that the headache often disappears promptly after application of the blood patch.…”

Section: Discussionmentioning

confidence: 99%

“…The headache may be intolerable (1)(2)(3)(4) and can continue for days and even for weeks. In most cases it is of temporary nature, but specific treatment such as application of epidural blood patch is sometimes necessary for its disappearance (4,5). The mechanisms behind post-spinal headache are still unknown.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms behind postspinal headache and brain stem compression following lumbar dural puncture – a physiological approach

Grände

2005

Acta Anaesthesiol Scand

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Mechanisms behind postspinal headache and brain stem compression following lumbar dural puncture -a physiological approach.Grände, Per-Olof 619-626. DOI: 10.1111619-626. DOI: 10. /j.1399619-626. DOI: 10. -6576.2004 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Methods: Hydrostatic effects of distal opening of the dural sac towards the atmosphere are described and applied to the normal brain and the brain with disrupted BBB. Analogue analyses from an isolated skeletal muscle enclosed in a rigid shell were applied to the brain in an attempt to simulate and verify haemodynamic effects of distal opening of the spinal canal. Results Conclusion:The present study strongly suggest that post-spinal headache and brain stem compression and other LP-related effects are predictable following LP, without involving CSF leakage, and can be explained by hydrostatic effects triggered by distal opening of the normally closed dural space to the atmosphere.

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Epidural blood patch for management of postdural puncture headache in adolescents

Abstract: Epidural blood patch seems to be an effective and safe procedure in adolescents for treating severe and persistent PDPH.

Cited by 41 publications

References 24 publications

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

Post-dural puncture headaches in children. A literature review

Mechanisms behind postspinal headache and brain stem compression following lumbar dural puncture – a physiological approach

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