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A prospective double‐blind clinical trial, comparing the sharp Quincke needle (22G) with an “atraumatic” needle (22G) in the induction of post‐lumbar puncture headache
Author(s) -
Braune H.J.,
Huffmann G.
Publication year - 1992
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1992.tb08053.x
Subject(s) - medicine , post dural puncture headache , lumbar puncture , anesthesia , cerebrospinal fluid , surgery , double blind , lumbar , dura mater , spinal anesthesia , placebo , pathology , alternative medicine
Posture‐dependent, post‐lumbar puncture headache is most likely caused by continuous leakage of cerebrospinal fluid through the dura mater perforation with a consecutive downward sagging of the intracranial content and an irritation of pain‐sensitive structures of meninges and blood vessels. A psychogenic co‐factor may also play a role. It is generally acknowledged that the incidence and intensity of the headache correlate significantly with the diameter of the needles used. A second factor, the shape of the needle point plays a crucial role as is shown in our prospective, double‐blind, clinical trial with 75 patients: employment of the “atraumatic” Sprotte needle with a rounded off point significantly reduced the incidence of postpuncture headache from 36% to 4%. Beside the discussion of pathogenic factors, remarks on a rational therapy are made.