[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. 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.
Grygorczuk
Sambor
S
Klinika Chorób Zakaźnych i Neuroinfekcji, Akademia Medyczna, ul. Zurawia 14, 15-540 Białystok. neuroin@amb.edu.pl
Pancewicz
Sławomir
S
Zajkowska
Joanna
J
Kondrusik
Maciej
M
Hermanowska-Szpakowicz
Teresa
T
D017217:Blood Patch, Epidural / Q000379:methods*; D006801:Humans; D019585:Intracranial Hypotension / Q000209:etiology / Q000473:pathology; D007427:Intracranial Pressure; D009339:Needles / Q000009:adverse effects; D009462:Neurology / Q000295:instrumentation / Q000379:methods; D051299:Post-Dural Puncture Headache / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D013129:Spinal Puncture / Q000009:adverse effects* / Q000145:classification