• Ann Emerg Med · Sep 2021

    Review

    Preventing Post-Lumbar Puncture Headache.

    • Emmanuel Cognat, Berengère Koehl, Matthieu Lilamand, Stéphane Goutagny, Anissa Belbachir, Louise de Charentenay, Tamazoust Guiddir, Paul Zetlaoui, Caroline Roos, and Claire Paquet.
    • Université de Paris, UMRS 1144, INSERM, Paris, France; Centre de Neurologie Cognitive, Assistance Publique Hôpitaux de Paris, APHP.Nord, Site Lariboisière Fernand-Widal, Paris France. Electronic address: emmanuel.cognat@aphp.fr.
    • Ann Emerg Med. 2021 Sep 1; 78 (3): 443-450.

    AbstractPost-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.Copyright © 2021 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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