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Post-lumbar puncture headache

Sébastien Héritier, Héloïse Torchin, Aude Verstraete, Nathalie De Suremain, Guy Leverger, Ricardo Carbajal, Arnaud Petit
Pediatric lumbar puncture : indications, execution and complications. Lumbar puncture (LP) is a commonly performed procedure with specific indications and technical considerations in pediatrics. The principal indication is for the diagnosis of central nervous system infection, but in case of meningitis in infants, nuchal rigidity may be absent and the clinical picture is more likely to be marked by axial hypotonia associated with abnormal behavior and/or a bulging fontanel. Pharmacological agents and non-pharmacological techniques (reassuring approach, distraction, presence of a parent) should be used whenever possible, to create successful environmental conditions for the completion of the LP procedure in childhood...
April 2018: La Revue du Praticien
Michael D Perloff, Simy K Parikh, Franchesca Fiorito-Torres, Matthew T McAdams, Melissa L Rayhill
BACKGROUND: Although lumbar punctures (LPs) are used for diagnostic evaluation in idiopathic intracranial hypertension (IIH), they can also provide relief from IIH-associated headache. Conversely, low-pressure headache secondary to LP can be debilitating. Low-volume cerebrospinal fluid (CSF) removal to a "high-normal" closing pressure (CP), approximately 18-20 cm H2O, may result in relief of IIH-associated headache with a lowered frequency of post-LP headache. METHODS: We conducted a single-center retrospective analysis from 2011 to 2016 of patients who underwent fluoroscopic LPs aiming for high-normal CPs...
February 18, 2019: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Domizia Vecchio, Paola Naldi, Veronica Ferro, Cristoforo Comi, Maurizio Angelo Leone, Roberto Cantello
BACKGROUND: Lumbar puncture (LP) is a safe procedure commonly performed in the diagnostic work-up of multiple sclerosis (MS), and its main adverse event is post-LP headache (PLPH). Predictors for PLPH in MS are not established. AIMS: To describe the occurrence of, and, factors related to PLPH in patients with suspected MS, studied on a daily-basis admission. PATIENTS AND METHODS: One hundred patients (70 females) were admitted for a diagnostic LP (standardized with a traumatic 19-G needle), observed for 6 h, and evaluated for adverse events 2 and 7 days later...
January 21, 2019: Neurological Sciences
Anna Bjornson, Ian Tapply, Eva Nabbanja, Afrodite-Despina Lalou, Marek Czosnyka, Zofia Czosnyka, Brinda Muthusamy, Matthew Garnett
PURPOSE: To determine the outcome of ventriculo-peritoneal shunts as a treatment for idiopathic intracranial hypertension (IIH) Materials and Methods: Retrospective case series of 28 patients with IIH and evidence of raised intracranial pressure (ICP) who underwent shunt insertion. Patients were identified from a prospectively updated operative database. A case-notes review was performed and data on type of shunt, pre- and post-operative symptoms, ophthalmological findings and post-operative complications were recorded...
January 17, 2019: British Journal of Neurosurgery
Michael Zhang, Tej D Azad, Harminder Singh, Smeer Salam, Saurabh Jain, Vijay K Anand, Theodore H Schwartz
Objectives  The use of intrathecal fluorescein (ITF) has become an increasingly adopted practice for the identification of cerebrospinal fluid (CSF) leaks during endoscopic skull base surgery for pituitary adenomas. Administration through lumbar puncture can result in postoperative positional headaches, increasing morbidity, cost, and length of stay. We sought to identify the incidence of and variables associated with postoperative headaches to determine if there was a subgroup of patients in whom this procedure should be avoided...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Kaavya Narasimhalu, Simon Kang Seng Ting, Shih Hui Lim
No abstract text is available yet for this article.
October 2018: Singapore Medical Journal
Deby Mukendi, Jean-Roger Lilo Kalo, Tharcisse Kayembe, Pascal Lutumba, Barbara Barbé, Philippe Gillet, Jan Jacobs, Cedric P Yansouni, François Chappuis, Kristien Verdonck, Marleen Boelaert, Andrea S Winkler, Emmanuel Bottieau
Analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) is an essential step for the diagnostic approach of neurological disorders, in particular neuro-infections. In low-resource settings, it is even often the only available diagnostic method. Despite its key contribution, little is known on the risks and benefits of LP in the large tropical areas where hospital-based neuroimaging is not available. The objectives of this study were to assess the safety and diagnostic yield of LP in a rural hospital of central Africa and to identify predictors of CSF pleocytosis (white blood cell count >5/μL) as surrogate marker of neuro-infections...
October 15, 2018: Journal of the Neurological Sciences
Melanie K Claborn, Debra L Stevens, Cheri K Walker, Brooke L Gildon
OBJECTIVE: To review the efficacy and safety of nusinersen (Spinraza) in the treatment of spinal muscular atrophy (SMA). DATA SOURCES: An English-language literature search of PubMed and MEDLINE (1946 to June 2018) was performed using the terms nusinersen, ISIS-SMN (Rx), and spinal muscular atrophy. Manufacturer prescribing information, abstracts, article bibliographies, and data were incorporated for additional materials. STUDY SELECTION/DATA EXTRACTION: All clinical trials of nusinersen were identified and analyzed in the review...
July 1, 2018: Annals of Pharmacotherapy
Fu-Hui Dong
The miminally-invasive techniques of traditional Chinese medicine(TCM) uses different types of acupuncture needles to treat diseased locations with special techniques. These techniques include different methods of insertion and closed incision (press cutting, sliding cutting, scrape cutting, etc.). This needling technique is based on the traditional Chinese medicine theories of Pi Bu (cutaneous), Jing Jin (sinew), Jing Luo (meridian), Wu Ti (five body structure components) and Zang Fu (organ system). Commonly used needles include: needle Dao , needle with edge, Pi needle, Shui needle, Ren needle, Gou needle, Chang Yuan needle, Bo needle and so on...
June 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Emma Stanhope, Lynsey Foulds, Gamal Sayed, Ute Goldmann
BACKGROUND: Headache is one of the most common symptoms following delivery and the underlying cause may be benign or life threatening. Identification of the cause of headache in the postpartum period can be challenging and relies on a comprehensive history and thorough examination, with particular focus on the presence or absence of neurological signs, which may suggest a more serious diagnosis (Nelson-Piercy 2010 ). However, through clinical experience and research, we have noted that post-partum headache is significantly under-recognised and treated (Goldszmidt et al...
July 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Joseph Atallah, Emmanuel Gage, Jonathan Koning, Joan Duggan, Vicki Ramsey-Williams, Samuel Scott, Daniel Gaudin, Mazin Sarhan
Background Post dural puncture headache (PDPH) is an iatrogenic cause of patient morbidity in pain management after spinal or epidural anaesthesia, as well as after diagnostic lumbar puncture. Most patients respond to conservative treatment or to epidural blood patch, yet limited options for effective treatment are available for patients who fail these treatments or present with theoretical contraindication. Case report We present a case of a patient with previously diagnosed human immunodeficiency virus and hepatitis C, who presented with signs of PDPH, which placed him at a theoretical risk of meningeal seeding of the virus during the blood patching procedure...
July 1, 2014: Scandinavian Journal of Pain
Joseph Jankovic, Ira Goodman, Beth Safirstein, Tonya K Marmon, Dale B Schenk, Martin Koller, Wagner Zago, Daniel K Ness, Sue G Griffith, Michael Grundman, Jay Soto, Susanne Ostrowitzki, Frank G Boess, Meret Martin-Facklam, Joseph F Quinn, Stuart H Isaacson, Omid Omidvar, Aaron Ellenbogen, Gene G Kinney
Importance: Aggregated α-synuclein is believed to be central to the pathogenesis of Parkinson disease (PD). PRX002/RG7935 (PRX002) is a humanized monoclonal antibody designed to target aggregated forms of α-synuclein, thereby inhibiting neuron-to-neuron transfer of presumed pathogenic forms of α-synuclein, potentially resulting in neuronal protection and slowing disease progression. Objective: To evaluate the safety and tolerability of multiple intravenous infusions of PRX002 in patients with idiopathic PD...
October 1, 2018: JAMA Neurology
Andreas Yiangou, James Mitchell, Keira Annie Markey, William Scotton, Peter Nightingale, Hannah Botfield, Ryan Ottridge, Susan P Mollan, Alexandra J Sinclair
Background Headache is disabling and prevalent in idiopathic intracranial hypertension. Therapeutic lumbar punctures may be considered to manage headache. This study evaluated the acute effect of lumbar punctures on headache severity. Additionally, the effect of lumbar puncture pressure on post-lumbar puncture headache was evaluated. Methods Active idiopathic intracranial hypertension patients were prospectively recruited to a cohort study, lumbar puncture pressure and papilloedema grade were noted. Headache severity was recorded using a numeric rating scale (NRS) 0-10, pre-lumbar puncture and following lumbar puncture at 1, 4 and 6 hours and daily for 7 days...
January 1, 2018: Cephalalgia: An International Journal of Headache
Phillip Chan, Joanna Hellmuth, Donn Colby, Eugene Kroon, Carlo Sacdalan, James Fletcher, Payal Patel, Suteera Pinyakorn, Victor Valcour, Jintanat Ananworanich, Serena Spudich
Background:  Cerebrospinal fluid (CSF) sampling at the time of acute HIV infection (AHI) is crucial in understanding NeuroAIDS pathogenesis. Here, we report on the safety of performing a lumbar puncture (LP) during untreated AHI and follow-up after initiation of combination antiretroviral therapy (cART). Methods:  We reviewed clinical records of participants who took part in an AHI protocol in Bangkok, Thailand, including untreated AHI subjects (baseline), and longitudinal visits following immediate initiation of cART to assess rates and risk of post-lumbar puncture headaches (PLPH)...
January 1, 2018: Journal of Virus Eradication
D R Nascene, C Ozutemiz, H Estby, A M McKinney, J B Rykken
Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1...
May 2018: AJNR. American Journal of Neuroradiology
Mery Zaina, Valentina Bressan, Loretta Caporale
AIM: To identify how the bed rest period and the posture assumed by the patient after lumbar puncture can influence the onset of complications, and which nursing interventions to adopt in order to reduce the complications. METHOD: A rapid assessment review was performed and the electronic databases PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials were searched between 2001 and 2015. RESULTS: Initially, 407 studies were retrieved, and 5 of these publications were considered to be eligible for the purpose of the study,4 comparing different periods of bed rest and 1 comparing patients position...
October 2017: Professioni Infermieristiche
Andreas Ravn, Louise Feldborg Lyckhage, Rigmor Høland Jensen
In this case report a young man was admitted with fever and headache, and a lumbar puncture revealed viral meningitis. After discharge, the patient experienced persistent headache, which worsened, when he was in upright position. The condition was considered secondary to the meningitis. After 14 months, the patient was diagnosed with post-dural puncture headache and treated with an epidural blood patch (EBP). The patient experienced no headache for three months, whereafter it returned. Subsequent EBP's were unsuccessful...
February 5, 2018: Ugeskrift for Laeger
Oluwaseun O Akinduro, Olutomi T Akinduro, Vivek Gupta, Ronald Reimer, Osarenoma Olomu
BACKGROUND: Prolactinomas may rarely present with meningitis and cerebrospinal fluid (CSF) rhinorrhea secondary to erosion of the wall of the sella turcica. It is even more uncommon for this abnormal communication to be caused by an ectopic prolactinoma arising from the sphenoid sinus and eroding into the sella. This atypical growth pattern makes diagnosis very difficult because there may be no displacement of the normal pituitary gland. The first reported case of a patient with an ectopic prolactinoma originating within the sphenoid sinus presenting primarily with meningitis is presented, and the management strategy and surgical and nonsurgical treatment options are discussed...
April 2018: World Neurosurgery
Tonia Sabo, Charlene Supnet, Sushmita Purkayastha
BACKGROUND: Cerebral edema peaks 36-72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48-72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype...
April 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Krista L Moulder, Lilah M Besser, Duane Beekly, Kaj Blennow, Walter Kukull, John C Morris
OBJECTIVE: Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States. METHODS: A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). In all, 64 LP Requestor, 579 Patient/Initial, and 404 Patient/Follow-up surveys were collected...
October 2017: Alzheimer Disease and Associated Disorders
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