Preventing Post-Lumbar Puncture Headache

Cognat, Emmanuel; Koehl, Bérengère; Lilamand, Matthieu; Goutagny, Stéphane; Belbachir, A.; Charentenay, Louise de; Guiddir, Tamazoust; Zetlaoui, Paul; Roos, Caroline; Paquet, Claire

doi:10.1016/j.annemergmed.2021.02.019

Cited by 20 publications

(20 citation statements)

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“… 42 The most common side effects of lumbar puncture are back pain and headache, which are easily managed, while serious complications (infections, spinal and subdural cerebral hematoma, and cerebral venous thrombosis) are very rare (prevalence <0.01%). 41 , 42 , 43 Guidelines have been developed to reduce the risks of complications when lumbar puncture is used in daily neurological practice and highlight the need to use atraumatic needle tips. 41 Providing up‐to‐date education and audio‐visual information to physicians and patients can allay common misconceptions about the acceptability and safety of lumbar puncture.…”

Section: Barriers and Limitations To Csf Ad Biomarkers In Clinical Pr...mentioning

confidence: 99%

Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios

Bouwman

Frisoni

Johnson

et al. 2022

Alz & Dem Diag Ass & Dis Mo

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Biomarker testing is recommended for the accurate and timely diagnosis of Alzheimer's disease (AD). Using illustrative case narratives we consider how cerebrospinal fluid (CSF) biomarker tests may be used in different presentations of cognitive impairment to facilitate timely and differential diagnosis, improving diagnostic accuracy, providing prognostic information, and guiding personalized management in diverse scenarios. Evidence shows that (1) CSF ratios are superior to amyloid beta (Aβ)1‐42 alone; (2) concordance of CSF ratios to amyloid positron emission tomography (PET) is better than Aβ1‐42 alone; and (3) phosphorylated tau (p‐tau)/Aβ1‐42 ratio is superior to p‐tau alone. CSF biomarkers are recommended for the exclusion of AD as the underlying cause of cognitive impairment, diagnosis of AD at an early stage, differential diagnosis of AD in individuals presenting with other neuropsychiatric symptoms, accurate diagnosis of AD in an atypical presentation, and for clinical trial enrichment. Highlights Cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker testing may be underused outside specialist centers. CSF biomarkers improve diagnostic accuracy, guiding personalized management of AD. CSF ratios (amyloid beta [Aβ]1‐42/Aβ1‐40 and phosphorylated tau/Aβ1‐42) perform better than single markers. CSF ratios produce fewer false‐negative and false‐positive results than individual markers. CSF biomarkers should be included in diagnostic work‐up of AD and mild cognitive impairment due to AD.

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Section: Barriers and Limitations To Csf Ad Biomarkers In Clinical Pr...mentioning

confidence: 99%

Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios

Bouwman

Frisoni

Johnson

et al. 2022

Alz & Dem Diag Ass & Dis Mo

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“…Lumbar puncture is an invasive technique mainly performed for sampling Cerebrospinal Fluid (CSF) or injecting medications such as anesthetics (1)(2)(3). Post-dural Puncture Headache (PDPH) is prevalent among individuals undergoing lumbar puncture (4,5). This type of headache can be accompanied by hearing loss, tinnitus, etc.…”

Section: Introductionmentioning

confidence: 99%

Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

et al. 2021

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Objectives: Post-dural Puncture Headache (PDPH) is prevalent among individuals undergoing lumbar punctures. The non-invasive effect of some drugs, such as aminophylline on PDPH has been investigated in several clinical studies. As there is no comprehensive systematic review and meta-analysis about the preventive and therapeutic effects of aminophylline on PDPH in the literature, the clinical effectiveness of this drug on the prevention and/or treatment of PDPH will be assessed in this study. Methods: PubMed/MEDLINE, Embase, WoS (Clarivate Analytics), the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL Complete, Scopus, and Google Scholar as electronic databases will be precisely searched for clinical studies that assessed the effect of aminophylline on PDPH. Studies between 01-01-1980 and 30-06-2020 will be evaluated in this study, and there will not be any language restrictions. Contradictions between the reviewers within any phase of the study (screening, selecting, quality assessment, and data extraction) will be resolved by consensus; in case of unsolved disagreements, a third reviewer will eventually decide. The combination method will be applied according to the methodological resemblance in the selected articles using the Random Effect Model or the Fixed Effect Model. Also, for the included articles, forest plots will be drawn. For assessing statistical heterogeneity, the I2 statistic and the Q-statistic test will be applied. In addition, funnel plots will be used for assessing non-significant study effects and potential reporting bias. Furthermore, Egger’s and Begg’s tests will be done, and publication bias will be indicated by significant findings (P < 0.05). Conclusions: It is expected that the results of this study will be of benefit to researchers and clinicians for managing PDPH, and will be reported in conferences and publications.

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“…5 PDPH Consequences The occurrence of PDPH is problematic as it causes functional and socio-professional disability leading to increased patient morbidity, delayed discharge and increased readmission. 6 It is also associated with increased risks of major neurological and long-lasting complications. 7 Cases of persistent headache have been reported and chronic back pain as well.…”

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confidence: 99%

“…12 13 Neither bed rest nor fluid supplementation decreases the incidence of headache after dural puncture 14 ; bed rest may even worsen post-lumbar puncture headache. 6 Insertion of an intrathecal catheter at the site of ADP significantly reduces the incidence and severity of PDPH. 15 PDPH incidence after lumbar puncture using a 22 G Tuohy needle was higher than that after lumbar CSF drainage using an 18 G Tuohy needle, suggesting that catheter insertion may reduce PDPH risk.…”

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confidence: 99%

SP60 PDPH in non-obstetric population. A problem or myth? A problem

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2022

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9.0) domains received the lowest mean scores. ICC statistical analysis showed high magnitude of agreement between reviewers with a range of (0.790-0.988).Reflecting upon this quality appraisal, it is evident that the quality and methodologic rigor of BTcP guidelines can be improved upon in the future. These findings also elucidate the existing variability/discrepancies among guidelines in diagnostic criteria and management of BTcP ( Suresh et al. 2022). Conclusion A comprehensive pain management approach that addresses the various presentations of pain in patients with cancer is required, including appropriate management of breakthrough pain (Caraceni et al 2013). Because pain is heterogeneous, the best management of an individual's pain, including breakthrough pain in cancer, requires a thorough assessment to tailor the treatment strategies. The developed guidelines support this approach and recommend treating breakthrough pain using rapid-or short-acting opioids with pharmacodynamics that mirror the rapid onset and short duration of the presenting pain. This approach should be part of a comprehensive strategy to treat pain within the context of the primary disease trajectory, offering continuity of care and access to specialized Pain therapy and Palliative care services.

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Preventing Post-Lumbar Puncture Headache

Cited by 20 publications

References 46 publications

Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios

Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios

Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

SP60 PDPH in non-obstetric population. A problem or myth? A problem

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