Why Don’t All Individuals Who Undergo Dura Mater/Arachnoid Puncture Develop Postdural Puncture Headache?

Valença, Marcelo Moraes; Amorim, Jane Auxiliadora; Moura, Tiago Pacheco de

doi:10.5812/kowsar.22287523.3616

Cited by 14 publications

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“…Clinical observations provide the basis for one interesting hypothesis. For instance, stopping of CSF leakage caused by lumbar puncture needle hole requires a few hours . Such a small needle‐hole CSF leakage will be promoted by motion of the spinal joints and will increase, resulting in completed PLPH .…”

Section: Discussionmentioning

confidence: 99%

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Sex‐ and Age‐Related Differences in the Clinical and Neuroimaging Characteristics of Patients With Spontaneous Intracranial Hypotension: A Records Review

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…For instance, stopping of CSF leakage caused by lumbar puncture needle hole requires a few hours. 24 Such a small needle-hole CSF leakage will be promoted by motion of the spinal joints and will increase, resulting in completed PLPH. 25 Female sex and younger age are reported to be significant risk factors in the development of PLPH.…”

Section: Discussionmentioning

confidence: 99%

Sex‐ and Age‐Related Differences in the Clinical and Neuroimaging Characteristics of Patients With Spontaneous Intracranial Hypotension: A Records Review

et al. 2016

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“…That approach has recently not been proved to reduce the risk of PDPH as compared to the latter 32 . Although bed rest post LP had been described to reduce PDPH severity 1 or delay its onset 18 , several studies failed to prove it to be more effective than early ambulation after LP in the prevention of PDPH 10,33 . Despite the lack of evidence, we opted for keeping all patients resting in bed post LP for 1 hour.…”

Section: Discussionmentioning

confidence: 99%

Post-dural puncture headache incidence after cerebrospinal fluid aspiration. A prospective observational study

Martins

Toson

Souza

et al. 2020

Arq. Neuro-Psiquiatr.

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Background: Post-dural puncture headache (PDPH) is an iatrogenic condition following lumbar puncture (LP). Incidence is variable and often associated with young females. Technical features of the procedure (i.e. needle gauge) have been investigated; however there is no investigation on the method of cerebrospinal fluid (CSF) collection. Objective: To investigate whether mild CSF aspiration is associated with increased PDPH in selected patients. Methods: 336 subjects were eligible to the study. Data on 237 patients from a tertiary neurology hospital who underwent diagnostic LP from February 2010 to December 2012 were analysed. Patient demographics, lumbar puncture method, CSF biochemical characteristics, opening pressures, and a follow-up inquire on PDPH occurrence were collected. CSF was collected either by allowing free flow or by mild aspiration. Results: The aspiration arm (n=163) was comprised of 55.8% females with mean age of 52(35-69) years. Sex distribution was not different between the two arms (p=0.191). A significant larger amount of CSF was obtained in the aspiration arm (p=0.011). The incidence of PDPH in the aspiration arm was 16.5% versus 20.2% in the free flow arm, not statistically significant (p=0.489). No relevant associations emerged from the analyses in the subgroup aged <65 years. Conclusions: Aspiration of the CSF during LP was not associated with increased rates of PDPH compared to the standard method, particularly when larger amounts of CSF are required and ideal conditions are met. This is the first study looking into this matter, aiming to add safety to the procedure. Further randomized trials are required. Keywords: cerebrospinal fluid; headache; post-dural puncture headache; spinal puncture. RESUMOIntrodução: Cefaleia pós-punção dural (CPPD) é uma condição iatrogênica após punção lombar (LP). Incidência é variável; frequentemente associada a mulheres jovens. Características técnicas do procedimento (ex: calibre da agulha) foram investigadas; no entanto, não há investigação sobre o método de coleta do líquido cefalorraquidiano (LCR). Objetivo: Avaliar se aspiração leve do LCR está associada ao aumento da CPPD em pacientes selecionados. Métodos: 336 indivíduos foram elegíveis para o estudo. Dados de 237 pacientes em um hospital neurológico terciário que foram submetidos à PL diagnóstica de fevereiro de 2010 a dezembro de 2012 foram analisados. Coletamos dados demográficos dos pacientes, método da PL, características bioquímicas do LCR, pressões de abertura e ocorrência da CPPD. Todos as PLs ocorreram em decúbito lateral. O LCR foi coletado permitindo livre fluxo ou aspiração leve. Resultados: O grupo aspiração (n=163) apresentava 55,8% de mulheres, idade média de 52(35-69) anos. A distribuição por sexo não foi diferente entre os dois grupos (p=0,191). Uma quantidade maior de LCR foi obtida no grupo aspiração (p=0,011). A incidência de CPPD no grupo de aspiração foi de 16,5% versus 20,2% no fluxo livre, não estatisticamente significante (p=0,489). Nenhuma associação emergiu das análises n...

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“…The Federal University of Pernambuco has contributed to the study of headache for almost half a century since the first publication in 1968 . Wilson Farias da Silva, Marcelo Moraes Valença, Pedro Sampaio Rocha Filho, Joaquim Costa Neto, Waldmiro Serva, Fabíola Lys Medeiros, Hugo André Martins, and Daniella Araújo de Oliveira are a few of the researchers that have been involved in the study of different aspects of the diagnosis, physiopathology, and treatment of headache disorders in the Federal University of Pernambuco. Rubem Guedes has also published vast amounts of data on spreading depression, today considered an experimental model to study migraine.…”

Section: Publications In Headache Medicinementioning

confidence: 99%

Headache Research and Medical Practice in Brazil: An Historical Overview

2015

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Since the creation of the Brazilian Headache Society in 1978, substantial developments have taken place in both research and clinical practice in the field of headache medicine in Brazil. The Society now has almost 300 members throughout the country, actively working to improve the health of the general population and, in particular, diagnose and treat headache disorders. In addition, in a few large cities, such as São Paulo, Rio de Janeiro, Recife, Ribeirão Preto, Curitiba, and Porto Alegre, headache specialists have come together to promote research projects and increase knowledge in the field through MSc, PhD, and postdoctoral programs. Furthermore, scientific journals have emerged and books have been published to record and disseminate Brazilian scientific production in headache medicine. In this narrative review, we will briefly describe some important aspects of headache medicine in Brazil from prehistoric times to the present day, discuss the origin of headache medicine as a specialty in Brazil, the principal publications dealing with headache disorders, the use of plants and other unconventional forms of treatment used by faith healers, the main training centers, and the research produced to date by Brazilians. In conclusion, in recent years enormous progress has been made in headache medicine in Brazil stimulating us to review and expand our role in an increasingly international scenario.

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Why Don’t All Individuals Who Undergo Dura Mater/Arachnoid Puncture Develop Postdural Puncture Headache?

Cited by 14 publications

References 14 publications

Sex‐ and Age‐Related Differences in the Clinical and Neuroimaging Characteristics of Patients With Spontaneous Intracranial Hypotension: A Records Review

Sex‐ and Age‐Related Differences in the Clinical and Neuroimaging Characteristics of Patients With Spontaneous Intracranial Hypotension: A Records Review

Post-dural puncture headache incidence after cerebrospinal fluid aspiration. A prospective observational study

Headache Research and Medical Practice in Brazil: An Historical Overview

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