Preventing Post-Lumbar Puncture Headache

Preventing Post-Lumbar Puncture Headache.

Emmanuel Cognat (1) , Berengère Koehl (2, 3) , Matthieu Lilamand (4) , Stéphane Goutagny (5) , Anissa Belbachir (6) , Louise de Charentenay (7) , Tamazoust Guiddir (8) , Paul Zetlaoui (9) , Caroline Roos (10) , Claire Paquet (10, 11)

1 Genetique des Maladies Vasculaires
2 Hôpital Robert Debré
3 BIGR (UMR_S_1134 / U1134) - Biologie Intégrée du Globule Rouge
4 Centre de Neurologie Cognitive [Paris]
5 Hôpital Beaujon [AP-HP]
6 Service de réanimation médicale polyvalente [CHU Cochin]
7 CHV - Centre Hospitalier de Versailles André Mignot
8 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
9 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
10 Hôpital Lariboisière-Fernand-Widal [APHP]
11 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie

Post-lumbar puncture headache is the main adverse event from lumbar puncture and occurs in 3.5% to 33% of patients, causing functional and socio-professional disability. We searched the post-lumbar puncture headache literature and, based on this review and personal expertise, identified and addressed 19 frequently asked questions regarding post-lumbar puncture headache risk factors and prevention. Among the nonmodifiable factors, older age is associated with a lower incidence of post-lumbar puncture headache, while female sex, lower body mass index, and history of headache might be associated with increased risk. The use of atraumatic, noncutting needles is the most effective intervention for post-lumbar puncture headache prevention. These needles are not more difficult to use than cutting needles. Other commonly recommended measures (eg, fluid supplementation, caffeine) appear unhelpful, and some (eg, bed rest) may worsen post-lumbar puncture headache.

Domaines: Neurobiologie

Emmanuel Cognat, Berengère Koehl, Matthieu Lilamand, Stéphane Goutagny, Anissa Belbachir, et al.. Preventing Post-Lumbar Puncture Headache. Annals of Emergency Medicine, 2021, 78 (3), pp.443-450. ⟨10.1016/j.annemergmed.2021.02.019⟩. ⟨hal-03905447⟩