Spinal headaches after myelograms: comparison of needle types.

Prager, Jordan M.; Roychowdhury, Sudipta; Gorey, Michael T.; Lowe, Gina M.; Diamond, Cheryl W.; Ragin, Ann B.

doi:10.2214/ajr.167.5.8911197

Cited by 16 publications

(9 citation statements)

References 5 publications

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“…Since its introduction over 100 years ago, 1 lumbar puncture has become a routine procedure for neurologists, oncologists, emergency department physicians, pediatricians, radiologists, family practitioners, and anesthesiologists. [2][3][4][5][6] One of the most common and bothersome complications of lumbar puncture is postdural puncture headache (PDPH), which is characterized by distressing symptoms that include head-ache, back pain, dizziness, nausea, and vomiting. 7,8 Postdural puncture headache may follow spinal anesthesia, as first described by Bier in 1899, but also occurs following diagnostic lumbar puncture.…”

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confidence: 99%

Use of Atraumatic Spinal Needles Among Neurologists in the United States

et al. 2001

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confidence: 99%

Use of Atraumatic Spinal Needles Among Neurologists in the United States

et al. 2001

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“…This is confirmed in our results where 23 % of women reported headache after a lumbar examination versus 7 % of men. The association of young age and low body weight increases the incidence of headache in females [21,22]. This group of patients was avoided in centre 2, which may have contributed to the low rate of headache observed there.…”

Section: Discussionmentioning

confidence: 99%

“…The size and type of the needle used for puncturing are known to be contributing factor to leakage of CSF and to high frequencies of headache. Several investigators [18,22,24] demonstrated a much lower rate and severity of CSF leakage after use of a pencil-point Sprotte or Whitacre needle than of a classical bevel-tipped Quincke needle of the same size. In our study, the administration of contrast medium after lumbar puncture was performed with a 22 G beveltipped needle in centres 1 and 3 but with a 24 G Sprotte needle in centre 2.…”

Section: Discussionmentioning

confidence: 99%

Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial

et al. 2002

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The objective of the trial was to compare the safety and efficacy of the non-ionic, dimeric, isotonic contrast medium iodixanol (Visipaque 270 and 320 mgI/ml) with those of iotrolan (Isovist 300 mgI/ml) in myelography. After lumbar or cervical puncture, 315 patients were examined in a multicentre, double-blind, randomised, comparative myelography study. Image quality, changes in vital signs, immediate and delayed adverse events were registered. There was a tendency for better images with iodixanol 320 than with iodixanol 270 and iotrolan 300, but the overall quality was good or excellent with all products. The frequency of patients reporting adverse events and headache varied much across centres, but there was no statistically significant difference between the contrast media. The incidence of events was higher after lumbar puncture than after cervical puncture, in women rather than in men, and after puncture with a 22-gauge (G) bevel-tipped needle compared with a 24 G Sprotte needle. The frequency of headache did not correlate with the absence of pathology. The higher iodine concentration in iodixanol 320 could be an advantage for film quality. When compared with iotrolan 300, iodixanol 320 and 270 give similar incidences of adverse events, including headache.

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“…Qincke tipi iğneler keskin uca sahipken Pencil point iğneler "atravmatik'' olarak da bilinirler ve keskin olmayan uca sahiptirler. Birçok çalışmada, keskin uçlu iğnelerin atravmatik iğnelere oranla daha fazla beyin omurilik sıvısı (BOS) kaçağına neden olarak daha yüksek oranda PSBA'ya neden olduğu belirtilmektedir (14)(15)(16) . Ayrıca kullanılan iğnenin çapı ne kadar büyük olursa PSBA görülme riskinin de o kadar büyük olduğu bildirilmiştir (1,10,11) .…”

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Effect of intrathecal fentanyl on incidence of post-spinal headache

Yılmaz¹,

Findik²,

Öncül³

et al. 2017

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Spinal anestezi alt ekstremite cerrahilerinde sıklıkla yeğlenmektedir. Spinal anestezinin hasta konforunu bozan post spinal baş ağrısı gibi çeşitli komplikasyonlar bulunmaktadır. Biz bu çalışmada, heavy marcaine ilave edilen fentanilin post spinal baş ağrısı görülme sıklığı üzerine etkisini araştırmayı amaçladık. Gereç ve Yöntem: Variköz ven cerrahisi planlanan hastalar randomize iki gruba ayrıldı. Kontrol grubuna 15 mg hiperbarik bupivakain, çalışma grubuna 15 mg hiperbarik bupivakain+20 mcg fentanil uygulandı. Bulgular: İki yüz altı hastaya (116 erkek, 90 kadın) ait veri analiz edildi. Post spinal baş ağrısı görülme sıklığı gruplar arasında benzerdi. Post spinal baş ağrısı ile ilişkili olan değişkenlerin multivaryant regresyon analizinde boy, alkol kullanımı, deneme sayısı, girişim öncesi parsiyel oksijen satürasyon değeri ve girişim sonrası 10. dakika kalp hızı post spinal baş ağrısı için bağımsız risk faktörleri olarak saptandı. Sonuç: Spinal anestezi sırasında heavy marcaine ilave edilen 20 mcg fentanilin post spinal baş ağrısı üzerine etkisi bulunmadığını düşünmekteyiz. Ancak alkol kullanımı, lomber ponksiyon sayısı, bazal parsiyel oksijen satürasyon değeri ve girişim sonrası 10. dk. kalp hızı post spinal baş ağrısı için bağımsız risk faktörleri olarak saptandı. Bu değişkenlerle ilgili yeni çalışmalara gereksinim duyulduğu düşüncesindeyiz.

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Spinal headaches after myelograms: comparison of needle types.

Cited by 16 publications

References 5 publications

Use of Atraumatic Spinal Needles Among Neurologists in the United States

Use of Atraumatic Spinal Needles Among Neurologists in the United States

Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial

Effect of intrathecal fentanyl on incidence of post-spinal headache

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