title: [Post-dural (post-lumbar) puncture syndrome. Review and retrospective study at an emergency headache centre].
abstract: Post-lumbar puncture headache (PLPH) is a well-known syndrome resulting from spinal fluid leakage and delayed closure of a dural defect. The main symptom of PLPH is headache in upright posture relieved by lying down. Outcome is usually benign and complications are uncommon. The functional impact can however be important, leading to delayed discharge, sick leave and, if information delivery is ineffective, iterative consultations. Preventive measures have been published, but the prevalence of PLPH remains high (15 to 40% after diagnostic lumbar puncture). Needle size and type are probably the most important factors for reducing the risk of PLPH. Recovery can be rapid, within a few days. If PLPH persists after four days, an epidural blood patch should be discussed. The objective of this review is to summarize the literature on PLPH, and share the experience of our emergency headache center with an atraumatic 25-gauge needle (pencan, 0.5×90mm or 0.5×103mm, Braun, Germany).
authors.affiliation: Centre d'urgence des céphalées, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: caroline.roos@lrb.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Roos
authors.affiliation: Centre d'urgence des céphalées, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Concescu
authors.affiliation: Département d'anesthésie-réanimation, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Appa Plaza
authors.affiliation: Département d'anesthésie-réanimation, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Rossignol
authors.affiliation: Centre d'urgence des céphalées, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Valade
authors.affiliation: Département de neurologie, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
authors.forename: A
authors.initials: A
authors.lastname: Ducros
mesh_terms: D017217:Blood Patch, Epidural; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004867:Equipment Design; D006801:Humans; D009339:Needles; D059906:Neuroimaging; D051299:Post-Dural Puncture Headache / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D011187:Posture; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Aiguille; Blood patch; Céphalée; Headache; Lumbar puncture; Needle; Ponction lombaire