Epub ahead of print: de Almeida et al. Incidence of Post-Dural Puncture Headache in Research Volunteers. Headache. 2011 Jul 28. doi: 10.1111/j.1526-4610.2011.01959.x.
Objective: To determine the frequency and risk factors of post-LP headache (PLPH) in research volunteers.
Background: Despite increasing interest in measuring cerebrospinal fluid (CSF) biomarkers to investigate disease pathogenesis and diagnosis, previous case series have evaluated lumbar puncture (LP) safety only in clinical care. PLPH is a common complication after LP.
Methods: We determined the frequency of PLPH in adults volunteering for research, as well as the variables associated with the development of PLPH. Variables studied were body mass index (BMI), HIV serostatus, volume of CSF removed, number of previous LPs, use of pre-medication, LP position, lumbar space, number of needle passes, whether or not aspiration was used and several CSF variables.
Results: Of 675 LPs performed over 1 year, headache developed in 38 subjects (5.6%). Most PLPH (92%) resolved spontaneously or with conservative medical management; 3 required epidural blood patch. Greater headache risk was associated with lower BMI (BMI ≤25) and less prior LP experience (previous LPs). PLPH was not related to CSF volume removed or gender.
Conclusion: In this study, where tolerance to risk was low because LPs were done for research rather than clinical purposes and healthy controls were included, adverse effects were mild and self-limited.
“This study is reassuring in that the incidence of post-LP headache is lower than the figure we normally quote subjects, i.e. 10%. In addition, the majority resolved spontaneously.”
“An epidural blood patch is when we inject fresh blood taken from your arm into the space around the lower spine. The blood then clots and seals off the hole through witch the spinal fluid leaks. This is a very simple procedure.”
|Epidural blood patch|