Post-dural (post-lumbar) puncture headache: Risk factors and clinical features
Amorim JA et al. – 14/48 patients (29%) suffered none of the above–mentioned symptoms, indicating that a significant number of patients may suffer from PDPH in the absence of any symptoms apart from the headache itself. This suggests that a further analyses of existing studies should be made to determine if a criteria change may need consideration.Methods
- Six–hundred–and–forty patients (332 non–pregnant women and 308 men) aged 8–65 years underwent spinal anesthesia with Quincke 25G or 27G needles in elective surgery.
- Forty–eight (7.5%) of the patients developed PDPH.
- The binary logistic regression analysis identified as risk factors: gender [11.1% female vs. 3.6% male, OR 2.25 (1.07–4.73); p=0.03], age [11.0% 31–50 years of age vs. 4.2% others, OR 2.21 (1.12–4.36); p=0.02], previous history of PDPH [26.4% positive vs. 6.2% negative, OR 4.30 (1.99–9.31); p<0.01] and bevel orientation [16.1% perpendicular vs.5.7% parallel, OR 2.16 (1.07–4.35); p=0.03].
- The period of latency between lumbar puncture and headache onset range from 6 to 72 hours and the duration from 3 to 15 days.
- In 34/48 (71%) patients with PDPH, at least one of the following was present: neck stiffness, tinnitus, hypoacusia, photophobia, or nausea.