Risk factors for post lumbar puncture headache.
BACKGROUND
Lumbar puncture (LP) is complicated by headache in about one-third of patients. The aim of the study was to evaluate potential risk factors for post-LP headache.


METHODS
144 Patients undergoing diagnostic LP at a tertiary medical center completed questionnaires on fear of the procedure, pre-existing headache, and post-LP headache. Data on patient demographics, operator experience, and other procedure-related parameters were collected from hospital files.


RESULTS
The post-LP headache group (n=37, 27.6%) was characterized by a significantly younger age and higher proportion of women relative to the no-headache group (n=97); body mass index was similar. Both groups had similar levels of fear of the procedure and there was no correlation between intensity of patients' anxiety to the procedure and its occurrence. Patients with high opening pressure had higher levels of post-LP headache (28.6% vs. 18% p=0.078) and a history of headaches was significantly more prevalent in the post-LP-headache group (66.6% vs. 38.1%, p=0.003).


CONCLUSIONS
Fear of the procedure does not predispose to occurrence of post-LP headache while a history of headache and elevated intracranial pressure does. These findings may be related to the possible pathophysiology of the condition, namely a change in compliance and pressure gradients with resultant venous distention.
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: santech76@yahoo.com.
Alexander
A
Khlebtovsky
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sherry
S
Weitzen
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Israel
I
Steiner
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arie
A
Kuritzky
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ruth
R
Djaldetti
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shlomit
S
Yust-Katz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005239:Fear / Q000523:psychology; D005260:Female; D020773:Headache Disorders / Q000150:complications*; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D051299:Post-Dural Puncture Headache / Q000209:etiology*; D012307:Risk Factors; D013129:Spinal Puncture / Q000009:adverse effects* / Q000523:psychology*; D055815:Young Adult
Anxiety; Headache; Lumbar puncture; Post lumbar puncture headache; Risk factors