title: [Iatrogenic after spinal puncture technique. Prevalence study of headache and associated factors].
abstract: OBJECTIVE
  To determine the prevalence of headache following a transdural lumbar puncture and the risk factors involved.
  
  
  METHODS
  The method used was a prospective observation-based cohort study. Patients were recruited from the A and E Department, Neurology Service and Day Care Clinic. The following data were collected: physician's experience, number of punctures, variations in the plane, patient's posture, local anaesthetic, needle calibre and bevel, degrees of inclination, amount of liquid, fluid overload and whether or not rest is indicated after the puncture. After 48 hours, the appearance of headache (or not) was determined.
  
  
  RESULTS
  The sample consisted of 59 patients, 31 (52.5%) of whom were males. Mean age: 47 years; 32 patients (54.2%) came from A and E, 18 (30.5%) from Neurology and 9 (15.3%) from the Day Care Clinic. Forty-one (69.5%) received the lumbar puncture in a lateral decubitus position and 7 (11.9%) in a seated position. All the needles were bevelled, 21 (35.6%) with a calibre of 20 and 38 (64.4%) of calibre 22. Eight patients (13.56%) were without repose and 18 (33.3%) had no fluid overload. Twenty-three (38.98%) had post-lumbar-puncture headache, 12 (52.2%) of them females, with a mean age of 38.3 ± 16.4 years. The median of the headache intensity was 2.6. The mean time of appearance was seven hours. There were no differences for any of the factors studied, except the observed tendency towards a higher incidence of headache at younger ages.
  
  
  CONCLUSIONS
  Rates of post-lumbar-puncture headache in our series are high, and no differences were found in terms of the service where it was performed or experience. No influence was observed due to the amount of liquid extracted, the patient's position, the indication of repose or fluid overload.
authors.affiliation: Hospital General Universitario Reina Sofia, Murcia, Espana.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Bauset-Navarro
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Sánchez-Ortuño
authors.forename: Claudia
authors.initials: C
authors.lastname: Gómez-Cárdenas
authors.forename: Ainara
authors.initials: A
authors.lastname: Sanz-Monllor
authors.forename: César
authors.initials: C
authors.lastname: Cinesi-Gómez
authors.forename: Pascual
authors.initials: P
authors.lastname: Piñera-Salmerón
mesh_terms: D000328:Adult; D000368:Aged; D015170:Cerebrospinal Fluid Pressure; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D051299:Post-Dural Puncture Headache / Q000453:epidemiology* / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013129:Spinal Puncture / Q000009:adverse effects* / Q000379:methods