No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle

Kim, Sung R.; Chae, Hyun Seok; Yoon, Mi J; Han, Jung Hee; Cho, Kwang J; Chung, Sun Ju

doi:10.1186/1471-2377-12-1

Cited by 58 publications

(87 citation statements)

References 19 publications

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“…These studies found that the amount of CSF removed during spinal tap, the CSF opening pressure and the length of time of bed rest after dural puncture do not influence the incidence of PDPH. 5,32 The position in which lumbar puncture is performed and the time in sitting position after injection of local anaesthetics were also found not to influence the incidence of PDPH. 33 Similarly, there appears to be no evidence that antiseptic agents used for cleaning the skin and the types of local anaesthetic agents have any role in the pathogenesis of PDPH.…”

Section: Other Possible Risk Factors For Pdphmentioning

confidence: 97%

Postdural puncture headache: evidence-based review for primary care

Omole

Ogunbanjo

2015

South African Family Practice

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The promotion of epidural and spinal blocks as preferred and safe techniques for Caesarean section and the use of lumbar puncture for diagnostic and therapeutic purposes place patients at risk of developing postdural puncture headache (PDPH). This article reviews the literature for evidence that provides an approach to diagnosis and management of this condition for the primary care physician. A dull and throbbing, bilateral headache associated with changes in posture (worsened by sitting and standing, and better lying down), that develops within seven days of a lumbar puncture or an inadvertent dural puncture must raise the suspicion of PDPH. The exact causative mechanism is unclear but symptoms of PDPH are generally attributed to excessive loss of cerebrospinal fluid (CSF). The risk of PDPH is increased with the use of cutting and large-bore needles, and with horizontal orientation of the needle bevel. Given that symptoms overlap, other organic causes of headache such as intracerebral/subdural haemorrhage, pneumocephalus, central nervous system infections, adverse effects of anticoagulants and functional headaches such as migraine must be excluded. Although the initial management of PDPH comprises several conservative interventions, evidence is only available for the effectiveness of the usage of caffeine, analgesics, gabapectin, hydrocortisone, dexamethasone and cosyntropin. Epidural blood patch (EDBP) offers the most favourable outcomes for patients who fail to respond to conservative management. However, given the lack of skills for performing EDBP in primary care, such patients should be referred to secondary or tertiary level of care.

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Section: Other Possible Risk Factors For Pdphmentioning

confidence: 97%

Postdural puncture headache: evidence-based review for primary care

Omole

Ogunbanjo

2015

South African Family Practice

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“…However, because cognitive effects are secondary to biological changes in the brain, an appropriate biological test might more accurately reflect the disease process. Much recent work seeks to make AD diagnoses or predictions based on biological markers (Convit, de Asis, de Leon, Tarshish, De Santi, & Rusinek, 2000; Visser, Verhey, Hofman, Scheltens, & Jolles, 2002; Devanand, et al, 2008; Walhovd, et al, 2010; Clark & ADNI, 2011; Cui, et al, 2011; Furney, et al, 2011; Palmqvist, et al, 2012; Ye, et al, 2012; Zhang, Shen, & ADNI, 2012). Among the studies cited here that incorporate biological tests, those that include some form of cross-validation or a separate test set report accuracies ranging from 62% to 85%.…”

Section: Introductionmentioning

confidence: 99%

Latent information in fluency lists predicts functional decline in persons at risk for Alzheimer disease

Clark¹,

Kapur²,

Geldmacher³

et al. 2014

Cortex

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Objective We constructed random forest classifiers employing either the traditional method of scoring semantic fluency word lists or new methods. These classifiers were then compared in terms of their ability to diagnose Alzheimer disease (AD) or to prognosticate among individuals along the continuum from cognitively normal (CN) through mild cognitive impairment (MCI) to AD. Method Semantic fluency lists from 44 cognitively normal elderly individuals, 80 MCI patients, and 41 AD patients were transcribed into electronic text files and scored by four methods: traditional raw scores, clustering and switching scores, “generalized” versions of clustering and switching, and a method based on independent components analysis (ICA). Random forest classifiers based on raw scores were compared to “augmented” classifiers that incorporated newer scoring methods. Outcome variables included AD diagnosis at baseline, MCI conversion, increase in Clinical Dementia Rating-Sum of Boxes (CDR-SOB) score, or decrease in Financial Capacity Instrument (FCI) score. ROC curves were constructed for each classifier and the area under the curve (AUC) was calculated. We compared AUC between raw and augmented classifiers using Delong’s test and assessed validity and reliability of the augmented classifier. Results Augmented classifiers outperformed classifiers based on raw scores for the outcome measures AD diagnosis (AUC 0.97 vs. 0.95), MCI conversion (AUC 0.91 vs. 0.77), CDR-SOB increase (AUC 0.90 vs. 0.79), and FCI decrease (AUC 0.89 vs. 0.72). Measures of validity and stability over time support the use of the method. Conclusion Latent information in semantic fluency word lists is useful for predicting cognitive and functional decline among elderly individuals at increased risk for developing AD. Modern machine learning methods may incorporate latent information to enhance the diagnostic value of semantic fluency raw scores. These methods could yield information valuable for patient care and clinical trial design with a relatively small investment of time and money.

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“…Hay estudios que reportan una asociación no significativa entre el número de intentos de punciones durales y la CPPD 6,24,31,32,34,46 . Sin embargo, Seeberger y cols realizaron un estudio prospectivo con 8034 punciones durales encontrando asociación estadística, estos autores atribuyen la falta de consistencia de los resultados en estudios anteriores debido a un bajo poder estadístico 47 .…”

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“…Del mismo modo, no hay diferencia estadísticamente significativa de la prevalencia de CPPD entre reposo en decúbito supino y deambulación precoz posterior a la punción dural 46,48,49 . Así mismo, un estudio prospectivo realizado en una muestra pequeña …”

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Actualización sobre factores de riesgo para cefalea pospunción dural

Rodríguez-Márquez

Ortega

2015

Rev. Medicas UIS

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RESUMENIntroducción: La cefalea pospunción dural es la complicación más frecuente de la punción dural, reportando una incidencia que oscila entre el 10% y el 40%. El padre de la anestesia epidural, August Bier, reportó en 1899 el primer caso de cefalea pospunción dural atribuyéndola a la perdida de líquido cefalorraquideo. Existen dos teorías para explicar su origen; la primera es la teoría de la grieta y la segunda es la teoría de Monro-Kellie-Burrows. El conocimiento de los factores de riesgo permite predecir la probabilidad de desarrollar esta patología. Objetivo: Revisar la evidencia actual sobre los factores de riesgo implicados en su desarrollo. Metodología de búsqueda: Se realizó una búsqueda de la literatura en PubMed, Proquest, Biblioteca Virtual en Salud en el periodo comprendido entre el 14 y 30 de Noviembre del 2014. Conclusiones: La edad, sexo femenino, antecedente personal de cefalea pospunción dural, aguja traumática y orientación del bisel perpendicular son factores de riesgo con significancia estadística. Mientras que los resultados a partir de los estudios no son concluyentes para factores como bajo peso (IMC<25Kg/m 2 ), antecedente personal de cefalea, mayor calibre de la aguja, no reinserción del estilete y mayor número de intentos por punción. MÉD UIS. 2015;28(3):345-52.Palabras Clave: Cefalea Pospunción de la Duramadre. Factores de Riesgo. Causalidad. Update on risk factors for post-dural puncture headacheABSTRACT Introduction: Post-dural puncture headache is the most common complication of dural puncture, reporting an incidence ranging between 10% and 40%. The father of epidural anesthesia, August Bier, reported the first case of post-dural puncture headache in 1899, attributing it to cerebrospinal fluid loss. There are two theories to explain its origin; the first is the theory of the crack and the second is the theory of Monro-Kellie-Burrows. Knowledge of risk factors allows to predict the likelihood of developing this disease. Objective: To review the current evidence pertaining to the risk factors involved in its development. Research methodology: Conducted literature research in PubMed, ProQuest, and Virtual Library of Health in the period between the 14th and 30th of November of 2014. Conclusions: Age, female gender, personal history of post-dural puncture headache, traumatic needle and orientation of perpendicular bevel are all risk factors with statistical significance. While results from other studies were inconclusive for factors such as low weight (BMI<25Kg/m

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No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle

Cited by 58 publications

References 19 publications

Postdural puncture headache: evidence-based review for primary care

Postdural puncture headache: evidence-based review for primary care

Latent information in fluency lists predicts functional decline in persons at risk for Alzheimer disease

Actualización sobre factores de riesgo para cefalea pospunción dural

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