Intracranial hypotension syndrome: A post dural puncture headache?☆

Quintero, Iván Fernando; Candamil, Ángela; Mantilla, Jorge Humberto Mejía; Medina, Henry; Cadena, Fredy Ariza

doi:10.1097/01819236-201341010-00010

Cited by 1 publication

(2 citation statements)

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“…In a study made by Boon et al ., width and height of the interlaminar space decreased with age according to measurements obtained by anterior–posterior lumbar spine radiographs. [ 12 ] Failed attempts (dry tap) are generally the result of the fact that the patients lose correct positioning and the direction of the needle is altered. [ 1 ] The position relative to the bone structure may also be a factor in failed LP attempts.…”

Section: Discussionmentioning

confidence: 99%

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The effects of needle deformation during lumbar puncture

Özdemir

Demir

Varol

et al. 2015

Journal of Neurosciences in Rural Practice

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Objective:The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP.Materials and Methods:The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP.Results:A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent.Conclusion:Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

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Section: Discussionmentioning

confidence: 99%

“…IH is a disorder caused by brain descent due to a CSF leak resulting from diagnostic, therapeutic or spontaneous lesions. [ 12 ] There is strong evidence indicating that most cases of IH result from a persistent CSF leak. These leaks most commonly occur after dural puncture for diagnostic LP, myelography, or spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%