[Lowered incidence of post-lumbar puncture headache following the application of the second edition of the International Headache Society classification].
BACKGROUND
In 1988 the International Headache Society (IHS) published the 1st edition of its headache classification and the 2nd edition was completed in 2003. AIM. To determine whether there exist changes in the incidence of post-lumbar puncture headache depending on the edition of the IHS classification.


METHODS
Between 2002 and 2003 data was gathered prospectively for 78 patients who were submitted to a diagnostic lumbar puncture, 40 obstetric spinal anaesthesias and 516 non-obstetric spinal anaesthesias. The 1st edition was used and, after the appearance of the 2nd edition, the cases were recoded.


RESULTS
With the 1st edition, there were 31 out of 78 cases (39.7%) of post-puncture headache in diagnostic punctures, and when the 2nd edition was used, the number dropped to 10 cases (12.8%). The incidence of headache among patients who had undergone obstetric spinal anaesthesia was six cases out of a total of 40 (15%) using the 1st edition, and four cases with the 2nd edition (10%). The incidence of headache among patients after non-obstetric spinal anaesthesia was 80 cases out of a total of 516 (15.5%) when the 1st edition was utilised and 25 cases with the 2nd edition (4.85%).


CONCLUSIONS
To compare the incidences of post-lumbar puncture headaches obtained by diverse observers we need to know which edition was used, since there are considerable differences between the results obtained using one edition or the other. The main reason accounting for the discrepancy between the two editions is the compulsory association of some accompanying sign, since this was not a necessary criterion in the 1st edition but it is included in the 2nd.
González-Martínez
F
F
Servicio de Urgencias, Hospital Virgen de la Luz, 16002 Cuenca, Spain. fgonmar@mailpersonal.como
de León-Belmar
J
J
Navarro-Gutierrez
S
S
Herráiz-de Castro
C
C
Montero-López
L
L
Liaño-Martínez
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002648:Child; D005260:Female; D006261:Headache / Q000145:classification / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000009:adverse effects*