Hodepine etter spinalpunksjon

Alstadhaug, Karl Bjørnar; Odeh, Francis; Baloch, Farid Khan; Berg, Diana Hristova; Salvesen, Rolf

doi:10.4045/tidsskr.11.0832

Cited by 31 publications

(27 citation statements)

References 38 publications

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“…PDPH is considered to be caused by the hole left in the dura after the lumbar puncture needle has been withdrawn, which can allow CSF leakage from the subarachnoid space [14]. Among the various risk factors for PDPH including puncture procedure variables, patient characteristics, and a past history of chronic headaches, the size and design of the needle used for the lumbar puncture are the most significant determinants of PDPH [2,3,15]. As a result, its incidence can vary widely, depending on the population involved and the needles and techniques used [3,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Among the various risk factors for PDPH including puncture procedure variables, patient characteristics, and a past history of chronic headaches, the size and design of the needle used for the lumbar puncture are the most significant determinants of PDPH [2,3,15]. As a result, its incidence can vary widely, depending on the population involved and the needles and techniques used [3,16,17]. The incidence of PDPH in this study (14%) was comparable to that described in a previous report in which 20G cutting spinal needles were used [18].…”

Section: Discussionmentioning

confidence: 99%

“…The lumbar puncture procedures were mainly performed using 21-gauge (G) Quincke spinal needles at the L3/4 or L4/5 intervertebral level. PDPH was diagnosed according to the previously published diagnostic criteria [3]. …”

Section: Methodsmentioning

confidence: 99%

“…However, puncturing the dura has the potential to lead to excessive CSF leakage, and CSF hypovolemia subsequent to excessive CSF leakage can lead to post-dural puncture headache (PDPH), which has been regarded as a complication of lumbar puncture for over a century [1]. Its clinical characteristics including its incidence and associated factors have been evaluated in previous studies [2,3]. …”

Section: Introductionmentioning

confidence: 99%

“…Considering its pathophysiology, it is indisputable that postpuncture CSF leakage contributes to the development of PDPH [2,3]. However, the incidence and clinical implications of radiologically visualized postpuncture CSF leakage have rarely been evaluated [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?

et al. 2013

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BackgroundPost-dural puncture headache (PDPH) due to excessive cerebrospinal fluid (CSF) leakage is a well-known complication of lumbar puncture. Although various factors, especially the type of spinal needle, have been demonstrated to be associated with PDPH, the clinical implications of CSF leakage detected on magnetic resonance myelography (MRM) images remain unclear. The objective of this case–control study was to evaluate the association between radiologically visualized CSF leakage and PDPH.MethodsClinical data including patients’ age and gender, types of spinal needle, duration of bed rest, interval between lumbar puncture procedures and MRM studies, and incidence of PDPH were compared between patients who were radiologically-positive and -negative for CSF leakage.ResultsOf the 22 patients with definite CSF leakage on MRM images, most were asymptomatic (86%, 19/22). The remaining three patients, who were suffering from PDPH, only complained of headaches and were treated conservatively. In a review of patients’ clinical data, there were no significant differences in any parameter including the incidence of PDPH between the 22 patients who were radiologically-positive for CSF leakage and the 31 radiologically-negative patients.ConclusionThe significance of radiologically visualized CSF leakage should not be overestimated, as most such incidents are not associated with PDPH and do not require any treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?

et al. 2013

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Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

Arévalo-Rodríguez¹,

Muñoz²,

Arevalo³

et al. 2013

Cochrane Database of Systematic Reviews

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Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

Arévalo-Rodríguez

Muñoz

Godoy‐Casasbuenas

et al. 2017

Cochrane Database of Systematic Reviews

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There is moderate-quality evidence that atraumatic needles reduce the risk of post-dural puncture headache (PDPH) without increasing adverse events such as paraesthesia or backache. The studies did not report very clearly on aspects related to randomization, such as random sequence generation and allocation concealment, making it difficult to interpret the risk of bias in the included studies. The moderate quality of the evidence for traumatic versus atraumatic needles suggests that further research is likely to have an important impact on our confidence in the estimate of effect.

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Hodepine etter spinalpunksjon

Abstract: Headache frequently occurs after lumbar puncture. There is substantial evidence for recommending the use of a thin, atraumatic needle to reduce the incidence. For practical reasons, a needle thinner than 22 G is not suitable for diagnostic lumbar puncture.

Cited by 31 publications

References 38 publications

Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?

Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?

Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

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