Abstract
Introduction: Post-dural puncture headache is the most common complication of dural puncture, reporting an incidence ranging between 10% and 40%. The father of epidural anesthesia, August Bier, reported the first case of post-dural puncture headache in 1899, attributing it to cerebrospinal fluid loss. There are two theories to explain its origin; the first is the theory of the crack and the second is the theory of Monro-Kellie-Burrows. Knowledge of risk factors allows to predict the likelihood of developing this disease. Objective: To review the current evidence pertaining to the risk factors involved in its development. Research methodology: Conducted literature research in PubMed, ProQuest, and Virtual Library of Health in the period between the 14th and 30th of November of 2014. Conclusions: Age, female gender, personal history of post-dural puncture headache, traumatic needle and orientation of perpendicular bevel are all risk factors with statistical significance. While results from other studies were inconclusive for factors such as low weight (BMI<25Kg/m2), personal history of headaches, increased size of needle, no reinsertion of stylet and a high number of attempts to puncture. MÉD UIS. 2015;28(3):345-52.
Keywords: Post-Dural Puncture Headache. Risk Factors. Causality.
References
Gaiser RR. Postdural puncture headache: a headache for the patient and a headache for the anesthesiologist. Current Opinion in Anaesthesiology. 2013;26(3):296-303.
Alstadhaug KB, Odeh F, Baloch FK, Berg DH, Salvesen R.Post-lumbar puncture headache. Tidsskr Nor Laegeforen. 2012;132(7):818-21.
Amorim JA, Gomes de Barros MV, Valença MM. Post-dural (postlumbar) puncture headache: risk factors and clinical features. Cephalalgia. 2012;32(12):916-23.
Bezov D, Ashina S, Lipton R. Post-Dural Puncture Headache: Part II - Prevention, Management, and Prognosis. Headache. 2010;50(9):1482-1498.
Kuczkowski KM. Postdural puncture headache after lumbar puncture: Do the gauge and the design of a spinal needle matter? Am J Emerg Med. 2006;24(6):757.
van Oosterhout WP, van der Plas AA, van Zwet EW, Zielman R, Ferrari MD, Terwindt GM. Postdural puncture headache in migraineurs and nonheadache subjects: a prospective study. Neurology. 2013;80(10):941-8.
Kuntz KM, Kokmen E, Stevens JC, Miller P, Offord KP, Ho MM. Post-lumbar puncture headaches: experience in 501 consecutive procedures. Neurology. 1992;42(10):1884-7.
de Almeida SM, Shumaker SD, LeBlanc SK, Delaney P, MarquieBeck J, Ueland S, et al. Incidence of post-dural puncture headache in research volunteers. Headache. 2011;51(10):1503-10.
Harrington BE. Postdural puncture headache and the development of the epidural blood patch. Reg Anesth Pain Med. 2004;29(2):136-63.
Amorim JA, Valença MM. Postdural puncture headache is a risk factor for new postdural puncture headache. Cephalalgia. 2008;28(1):5-8.
Singh S, Chaudry SY, Phelps AL, Vallejo MC. A 5-year audit of accidental dural punctures, postdural puncture headaches, and failed regional anesthetics at a tertiary-care medical center. TheScientificWorldJournal. 2009; 9:715-722.
International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808.
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004; 24 (suppl 1):79.
Calderon R, Copehaver D. Postdural puncture headache. Journal of pain & palliative care pharmacotherapy. 2013;27(4):406-407.
Bezov D, Lipton RB, Ashina S. Post-Dural Puncture Headache: Part I Diagnosis, Epidemiology, Etiology, and Pathophysiology. Headache. 2010 ;50(7):1144-1152.
Dodge HS, Ekhator NN, Jefferson-Wilson L, Fischer M, Jansen I, Horn PS, et al. Cigarette smokers have reduced risk for post-dural puncture headache. Pain physician. 2013;16:E25-E30.
Zetterberg H, Tullhög K, Hansson O, Minthon L, Londos E, Blennow K. Low incidence of post-lumbar puncture headache in 1,089 consecutive memory clinic patients. Eur Neurol. 2010;63(6):326-330.
Janssens E, Aerssens P, Alliët P, Gillis P, Raes M. Post-dural puncture headaches in children. A literature review. Eur J Pediatr. 2003;162(3):117-21.
Ramamoorthy C, Geiduschek JM, Bratton SL, Miser AW, Miser JS. Postdural puncture headache in pediatric oncology patients. Clin Pediatr. 1998;37(4):247-51.
Wu CL, Rowlingson AJ, Cohen SR, Michaels RK, Courpas GE, Joe EM, et al. Gender and post-dural puncture headache. Anesthesiology. 2006;105(3):613-18.
Vilming ST, Kloster R, Sandvik L. The importance of sex, age, needle size, height and body mass index in post-lumbar puncture headache. Cephalalgia. 001;21(7):738-43.
Vricella LK, Louis JM, Mercer BM, Bolden N. Anesthesia complications during scheduled cesarean delivery for morbidly obese women. Obstet Gynecol. 2010;203(3):276.e1-5.
Faure E, Moreno R, Thisted R. Incidence of postdural puncture headache in morbidly obese parturients. Reg Anesth. 1994;19(5):361-3.
Lybecker H, Møller JT, May O, Nielse n HK. Incidence andprediction of postdural puncture headache. A prospective study of 1021 spinal anesthesias. Anesth Analg. 1990;70(4):389-94.
Nowaczewska M, Ksikiewicz B. Cerebral blood flow characteristics in patients with post-lumbar puncture headache. J Neurol. 2012;259(4):665-9.
Webb CA, Weyker PD, Zhang L, Stanley S, Coyle DT, Tang T, et al. Unintentional dural puncture with a Tuohy needle increases risk of chronic headache. Anesth Analg. 2012;115(1):124-32.
Müller B, Adelt K, Reichmann H, Toyka K. Atraumatic needle reduces the incidence of post-lumbar puncture syndrome. J Neurol. 1994; 241(6):376-80.
Birnbach DJ, Kuroda MM, Sternman D, Thys DM. Use of atraumatic spinal needles among neurologists in the United States. Headache. 2001;41(4):385-90.
Lavi R, Rowe JM, Avivi I. Lumbar Puncture: It Is Time to Change the Needle. Eur Neurol. 2010;64(2):108-13.
Lowery S, Oliver A. Incidence of postdural puncture headache and backache following diagnostic/therapeutic lumbar puncture using a 22G cutting spinal needle, and after introduction of a 25G pencil point spinal needle. Paediatr Anaesth. 2008;18(3):230-4.
Hammond ER, Wang Z, Bhulani N, McArthur JC, Levy M. Needle type and the risk of post-lumbar puncture headache in the outpatient neurology clinic. J Neurol Sci. 2011;306(1-2):24-8.
Lavi R, Yarnitsky D, Rowe JM, Weissman A, Segal D, Avivi I. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial. Neurology. 2006;67(8):1492-4.
Strupp M, Schueler O, Straube A, Von Stuckrad-Barre S, Brandt T. “Atraumatic” Sprotte needle reduces the incidence of postlumbar puncture headaches. Neurology. 2001;57(12):2310-2.
Apiliogullari S, Duman A, Gok F, Akillioglu I. Spinal needle design and size affect the incidence of postdural puncture headache in children. Paediatr Anaesth. 2010;20(2):177-82.
Thomas SR, Jamieson DRS, Muir KW. Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture. Br Med J. 000;321(7267):986-90.
Davis A, Dobson R, Kaninia S, Espasandin M, Berg A, Giovannoni G, et al. Change practice now! Using atraumatic needles to prevent post lumbar puncture headache. EUR J NEUROL. 2014;21(2):305-11.
Tung CE, So YT, Lansberg MG. Cost comparison between the atraumatic and cutting lumbar puncture needles. Neurology. 2012;78(2):109-13.
Samayoa F, Ramos N, Sánchez A. Cefalea post punción dural al utilizar agujas de Quincke vrs. agujas de Whitacre en pacientes obstétricas. Rev. Colomb. Anestesiol. 2004;32:253-60.
López Correa T, Garzón Sánchez JC, Sánchez Montero FJ, Muriel Villoria C. Postdural puncture headache in obstetrics. REDAR . 2011;58(9):563-73.
Aamodt A, Vedeler C. Complications after LP related to needle type: pencil-point versus Quincke. Acta Neurol Scand. 2001;103(6):396-98.
Schmittner MD, Terboven T, Dluzak M, Janke A, Limmer ME, Weiss C, et al. High incidence of post-dural puncture headache in patients with spinal saddle block induced with Quincke needles for anorectal surgery: a randomised clinical trial. Int J Colorectal Dis. 2010;25(6):775-81.
Tarkkila PJ, Heine H, Tervo RR. Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache. Reg Anesth 1992;17(5):283-87.
Strupp M, Brandt T. Should One Reinsert the Stylet during Lumbar Puncture?. N Engl J Med. 1997;336(16):1190.
Strupp M, Brandt T, Müller A. Incidence of post-lumbar puncturesyndrome reduced by reinserting the stylet: a randomized prospective study of 600 patients. J Neurol. 1998;245(9):589-92.
Sinikoglu NS, Yeter H, Gumus F, Belli E, Alagol A, Turan N.Reinsertion of the stylet does not affect incidence of post dural Puncture Headaches (PDPH) after spinal anesthesia. Braz. j. anesthesiol. 2013;63(2):188-92.
Kim SR, Chae HS, Yoon MJ, Han JH, Cho KJ, Chung SJ. No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle. BMC Neurology. 2012;12:1.
Seeberger MD, Kaufmann M, Staender S, Schneider M, Scheidegger D. Repeated dural punctures increase the incidence of postdural puncture headache. Anesth Analg. 1996;82(2):302-5.
Tejavanija S, Sithinamsuwan P, Sithinamsuwan N, Nidhinandana S, Suwantamee J. Comparison of prevalence of post-dural puncture headache between six hour- supine recumbence and early ambulation after lumbar puncture in thai patients: A randomized controlled study. J. Med. Assoc. Thai. 2006;89(6):814-20.
Bauset-Navarro J, Sánchez-Ortuño I.M, Gómez-Cárdenas C, Sanz-Monllor A, Cinesi-Gómez C, Piñera-Salmerón P. Iatrogenic after spinal puncture technique. Prevalence study of headache and associated factors. Rev. Neurol. 2014;58(5):193-8.
Schmittner MD, Urban N, Janke A, Weiss C, Bussen DG, Burmeister MA, et al. Influence of the pre-operative time in upright sitting position and the needle type on the incidence of post-dural puncture headache (PDPH) in patients receiving a
spinal saddle block for anorectal surgery. Int. J. Colorectal. Dis. 2011;26(1):97-102.