[Post-dural (post-lumbar) puncture syndrome. Review and retrospective study at an emergency headache centre]

C Roos; D Concescu; P Appa Plaza; M Rossignol; D Valade; A Ducros

doi:10.1016/j.neurol.2014.02.004

[Post-dural (post-lumbar) puncture syndrome. Review and retrospective study at an emergency headache centre]

Rev Neurol (Paris). 2014 Jun-Jul;170(6-7):407-15. doi: 10.1016/j.neurol.2014.02.004. Epub 2014 Apr 13.

[Article in French]

Authors

C Roos¹, D Concescu², P Appa Plaza³, M Rossignol³, D Valade², A Ducros⁴

Affiliations

¹ Centre d'urgence des céphalées, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: caroline.roos@lrb.aphp.fr.
² Centre d'urgence des céphalées, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
³ Département d'anesthésie-réanimation, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
⁴ Département de neurologie, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.

PMID: 24726041
DOI: 10.1016/j.neurol.2014.02.004

Abstract

Post-lumbar puncture headache (PLPH) is a well-known syndrome resulting from spinal fluid leakage and delayed closure of a dural defect. The main symptom of PLPH is headache in upright posture relieved by lying down. Outcome is usually benign and complications are uncommon. The functional impact can however be important, leading to delayed discharge, sick leave and, if information delivery is ineffective, iterative consultations. Preventive measures have been published, but the prevalence of PLPH remains high (15 to 40% after diagnostic lumbar puncture). Needle size and type are probably the most important factors for reducing the risk of PLPH. Recovery can be rapid, within a few days. If PLPH persists after four days, an epidural blood patch should be discussed. The objective of this review is to summarize the literature on PLPH, and share the experience of our emergency headache center with an atraumatic 25-gauge needle (pencan, 0.5×90mm or 0.5×103mm, Braun, Germany).

Keywords: Aiguille; Blood patch; Céphalée; Headache; Lumbar puncture; Needle; Ponction lombaire.

Publication types

English Abstract
Review

MeSH terms

Blood Patch, Epidural
Emergency Medical Services / statistics & numerical data*
Equipment Design
Humans
Needles
Neuroimaging
Post-Dural Puncture Headache* / diagnosis
Post-Dural Puncture Headache* / epidemiology
Post-Dural Puncture Headache* / physiopathology
Post-Dural Puncture Headache* / prevention & control
Post-Dural Puncture Headache* / therapy
Posture
Prevalence
Retrospective Studies
Risk Factors