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Post‐lumbar Puncture Headache
Author(s) -
Spielman Fred J.
Publication year - 1982
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.1982.hed2206280.x
Subject(s) - medicine , anesthesia , muscle spasm , nausea , lumbar puncture , subarachnoid space , surgery , epidural blood patch , bed rest , cerebrospinal fluid , vomiting , complication , lumbar , intracranial hypotension , pathology
SYNOPSIS Headache is a frequent complication of dural puncture. Cerebrospinal fluid leakage from the subarachnoid space decreases the cushioning effect the fluid has on the brain, producing traction on nerves and blood vessels. The headache, worse when the patient's head is elevated, and usually located in the frontal and occipital regions, is often associated with neck stiffness and nausea. The symptoms typically occur the day after dural puncture and are normally limited to 5 or 6 days. The post‐lumbar puncture headache's incidence and severity are directly related to needle size. The mainstays of treatment are hydration and bedrest. Analgesics and tranquilizers can be used to relieve anxiety and muscle spasm. Severe symptoms unresponsive to conservative measures have been treated with an epidural blood patch. The success rate of this therapy is over 90 per cent.