The influence of using an atraumatic needle on the incidence of post-myelography headache

Abstract

The aim of this study was to investigate whether the incidence of headaches following myelography could be reduced by using a needle with an atraumatic tip. 107 patients were studied in a trial of 22 gauge atraumatic versus 22 gauge bevel tipped needles. In the first 3 days after myelography, there was a significant reduction in the incidence of headaches in patients in whom an atraumatic needle had been used.

The influence of early ambulation and other factors on headache after lumbar myelography

“…Many authors have noted spinal headache after myelography. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Some have stated that it is relieved by lying supine, and that it occurs after between 4.7% and 58.2% of myelographic procedures carried out under variable conditions. 2,3,[7][8][9][10][11]14 According to these reports, it usually begins within three days and lasts between three and five days.…”

“…8,13 Smaller-gauge needles, blunt-tip needles, and parallel orientation of bevel needles are associated with lower rates of headache. 1,[3][4][5][7][8][9][10]13,14 Patients with normal myelographic findings complain of headache more often than those with abnormal myelograms, including those with stenosis of the spinal canal. 2 Some authors have reported a higher incidence of headache after lumbar myelography in ambulatory groups, 12 while others have stated that lumbar myelography can be safely undertaken as an outpatient procedure.…”

Intrathecal Gadolinium for Magnetic Resonance Myelography in Spontaneous Intracranial Hypotension: Valuable But May Be Risky—Reply

“…[1][2][3] We assume that on the background of preexisting intracranial hypotension the leak produced by the diagnostic procedure does not make an important difference, especially if atraumatic needles are used. 4,5 The possible adverse effects must be considered in relation to the therapeutic consequences, which may include targeted blood patches and, in rare cases, surgical intervention. Clearly, the diagnostic and therapeutic approach in patients with SIH needs to be individually tailored and discussed with the patient so that informed decisions can be taken, being aware that without informative controlled studies, there is no general consensus on best practice in this relatively rare condition.…”

Complications of neuroimaging

“…A spinal headache generally begins within 3 days of the procedure and lasts 3-5 days. Studies by (Jones et al, 1994;Prager et al, 1996) reported a lower incidence of spinal headache when a pencil point needle was used compared to a beveled needle (Jones et al, 1994;Prager et al, 1996). The proposed mechanism for the postmyelography headache is continuous leakage of the CSF from the dural puncture site (Peterman, 1996).…”