Incidence of Post-Dural Puncture Headache in Research Volunteers

Abstract

Objective To determine the frequency and risk factors of post-dural puncture headache (PDPH) in research volunteers. Background Despite increasing interest in measuring cerebrospinal fluid biomarkers to investigate disease pathogenesis and diagnosis, previous case series have evaluated lumbar puncture (LP) safety only in clinical care. PDPH is a common complication after LP. Methods We determined the frequency of post-dural puncture headache (PDPH) in neurologically unselected HIV seropositive and seronegative adults volunteering for research, as well as the variables associated with the development of (PDPH). Variables studied were BMI, HIV serostatus, volume of CSF removed, number of previous LPs, use of pre-medication, LP position, lumbar space, number of needle passes, whether or not aspiration was used, CSF WBC, CSF RBC, CD4 count, CD4 nadir, CSF HIV viral load, plasma HIV viral load, and race. Results Of 675 LPs performed over one year, headache developed in 38 (5.6%; 95% CI 4.2, 7.1)). Most PDPH (92%) resolved spontaneously or with conservative medical management; 3 required epidural blood patch. Greater headache risk was associated with lower body mass index (BMI ≤ 25 versus > 25) (OR 3.3; CI 95% 1.5, 7.0; p=0.001) and less prior LP experience (previous LPs ≤ 2 vs > 2) (OR 2.1; CI 95% 1.1, 4.1; p=0.03). PDPH was not significantly (p > .05) related to HIV serostatus, CSF volume, or gender. Conclusion In this study, where tolerance to risk was low because LPs were done for research rather than clinical purposes and healthy controls were included, adverse effects were mild and self-limited.

Post Dural Puncture Headache (PDPH) and Associated Factors after Spinal Anesthesia among Patients in University of Gondar Referral and Teaching Hospital, Gondar, North West Ethiopia

“…This finding was similar with different studies [1,2,[4][5][6][22][23][24][25]. But in some studies no significant association was reported between gender and the incidence of PDPH [26,27].…”

“…On the other hand BMI, age of the patients and previous history of PDPH were not associated with the development of PDPH even though these variables (lower BMI, younger age, and previous history of PDPH) have reported as risk factors for PDPH in different studies [1,2,4,5,15,27]. This could be most likely due to the small sample size to compare different categories of BMI, age, and patients with and without previous history of PDPH in our study.…”

Assessment of the Prevalence and Associated Risk Factors of Post Dural Puncture Headache (PDPH) after Cesarean Section Delivery under Spinal Anesthesia

“…Even though different studies showed on variables of the lower BMI, younger age, and previous history of PDPH are listed as risk factors for PDPH development [5,14,20] , our observation study did not bring into being significant association between these variables and PDPH. This might be due to the lack of sample size to compare lower to higher BMI, young to old age, and patients with versus without previous history of PDPH.…”

Incidence of Post Dural Puncture Headache in Spinal Anaesthesia for Cholecystectomy

“…15 Another study done by Almeida et al, their 3 patients out of 38 required epidural blood patch. 24 A study done by Lybecker H et al, 75 patients complained of PDPH out of which 45 patients (60 %) recovered spontaneously and 30 patients (40 %) were treated with an autologous blood patch.…”

“…22 Lower incidence of PDPH were reported by Lybecker et al, Agarwal et al, Almeida et al and Myers et al The incidence of PDPH in their studies were 7.35 %, 5.9 %, 5.6 % and 0.3 % respectively. [23][24][25][26] In our study 23, 25 and 26 gauge spinal needles were used in 37, 141 and 22 patients respectively. 9 patients (24.3 %) complained of headache with 23 gauge needle, 13 patients (9.2 %) with 25 gauge needle and 1 patient (4.5 %) with 26 gauge needle during post operative period.…”