Abstract
Post-dural puncture headache (PDPH) is an unfavorable situation seen in considerable number of patients even though atraumatic and small needle reduces its incidence. CSF pressures measured at the time of puncture change after CSF drainage. In the present study, we investigated relationships between CSF pressure-related factors and occurrence of PDPH. We prospectively enrolled 103 participants who underwent CSF studies for meningitis. Using a standardized protocol, CSF opening pressure (OP) and closing pressure (CP) were measured, and cerebrospinal elastance (ECS) and pressure-volume index (PVI) were investigated. Within 14 days after dural puncture, we confirmed PDPH. According to PDPH development, the CSF pressure factors and clinical variables were compared between PDPH and non-PDPH group. Of the 103 participants, 100 (97.0%) had decreased CP, 16 (15.5%) had values below 6 cmH2O and the pressure change after dural puncture (OP-CP) was 6.1 ± 3.1 cmH2O. PVI and ECS measured by CSF drainage were 99.8 ± 89.5 and 0.4 ± 0.2 cmH2O/mL. Among the demographic factors, body weight was correlated with OP (r = 0.27), CP (r = 0.35), and PVI (r = 0.20). Height was weakly correlated with CP (r = 0.199) During the study period, 22 participants (21.34%) developed PDPH. None of the CSF pressure factors were significantly different between the PDPH and non-PDPH group and did not contributed to the development of PDPH. CSF pressure factors might not be related to the development of PDPH.
Highlights
Dural puncture is essential for the diagnosis of CNS infections and disorders related to CSF dynamics [1]
We investigated whether CSF pressure factors at the time of CSF examination are associated with subsequent development of Post-dural puncture headache (PDPH)
PDPH developed in 22 participants (21.4%) at 1.91 ± 1.41 days after lumbar puncture
Summary
Dural puncture is essential for the diagnosis of CNS infections and disorders related to CSF dynamics [1]. Post-dural puncture headache (PDPH) occurs in a considerable number of patients and causes difficulties for clinicians. Previous studies reported that the overall prevalence of PDPH was 20–40% with a conventional method, but smaller size and atraumatic needle could reduce the incidence to 3∼6% [1, 2]. PDPH occurs within 24–48 h after dural puncture, and ICHD-3 is defined as a headache within 5 days after CSF drainage [3]. PDPH is usually accompanied by neck stiffness and/or subjective hearing symptoms. Even though the majority of CSF Pressure Factors and PDPH patients recover spontaneously within 2 weeks, some require treatment with autologous epidural lumbar patches
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
