[Post-lumbar puncture syndrome--its pathogenesis,

Neurol Neurochir Pol · Sep 2006

Review

[Post-lumbar puncture syndrome--its pathogenesis, prophylaxis and treatment].

Post-lumbar puncture syndrome (PLPS) is a frequent and important complication of diagnostic lumbar puncture. PLPS is primarily caused by perforation of the dura mater, leading to persistent leak of the cerebrospinal fluid, and, as a result, intracranial hypotension. ⋯ Prophylactic measures of confirmed efficacy are: reducing needle size, positioning the needle bevel parallel to the long axis of the spine, re-inserting the stilet before withdrawal of the needle, and, if possible, using a so-called "atraumatic" needle, minimizing the perforation of the meninx. The volume of the cerebrospinal fluid collected and the position of the patient after the procedure do not have a significant influence on PLPS frequency.

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- Sambor Grygorczuk, Sławomir Pancewicz, Joanna Zajkowska, Maciej Kondrusik, and Teresa Hermanowska-Szpakowicz.
- Klinika Chorób Zakaźnych i Neuroinfekcji, Akademia Medyczna, ul. Zurawia 14, 15-540 Białystok. neuroin@amb.edu.pl
- Neurol Neurochir Pol. 2006 Sep 1;40(5):434-40.
AbstractPost-lumbar puncture syndrome (PLPS) is a frequent and important complication of diagnostic lumbar puncture. PLPS is primarily caused by perforation of the dura mater, leading to persistent leak of the cerebrospinal fluid, and, as a result, intracranial hypotension. Effective therapeutic options are limited to symptomatic treatment until natural improvement occurs, or, in cases of prolonged complaints, invasive treatment (epidural blood patch with patient's own venous blood), which makes prophylaxis of PLPS essential. Prophylactic measures of confirmed efficacy are: reducing needle size, positioning the needle bevel parallel to the long axis of the spine, re-inserting the stilet before withdrawal of the needle, and, if possible, using a so-called "atraumatic" needle, minimizing the perforation of the meninx. The volume of the cerebrospinal fluid collected and the position of the patient after the procedure do not have a significant influence on PLPS frequency.

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