Post-dural puncture headaches in children. A literature review

  title={Post-dural puncture headaches in children. A literature review},
  author={Elke Janssens and Peter Aerssens and Phillipe Alli{\"e}t and Phillipe Gillis and Marc Raes},
  journal={European Journal of Pediatrics},
Post-dural puncture headache (PDPH) is a well recognised complication of spinal and epidural anaesthesia. It can also occur after diagnostic or therapeutic lumbar puncture. Few cases have been reported in children. We reviewed the literature regarding definition, aetiology, incidence, risk factors, prevention and treatment, in order to provide some recommendations. Significant factors include age, gender, needle diameter, needle tip design, orientation of the tip during puncture, previous PDPH… 
Posture and fluids for preventing post-dural puncture headache.
This review identified randomized controlled trials that compared the effects of bed rest versus immediate mobilization, head-down tilt versus horizontal position, prone versus supine positions during bed rest, and administration of supplementary fluids versus no/less supplementation, as prevention measures for PDPH in people who have undergone lumbar puncture.
Post-lumbar puncture headache.
There is substantial evidence for recommending the use of a thin, atraumatic needle to reduce the incidence of post-dural puncture headache, and an epidural blood patch works well for the majority, but there is no consensus on when such treatment should be offered.
Prevention and Management of Post–Lumbar Puncture Headache in Pediatric Oncology Patients
  • Livia Lee, M. Sennett, J. Erickson
  • Medicine
    Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
  • 2007
The pathophysiology and incidence of headaches related to lumbar punctures in the pediatric oncology setting is outlined and the evidence from research trials is reviewed to suggest which interventions clinicians should adopt into their practice to minimize this complication.
Post‐Dural Puncture Headache: Part II – Prevention, Management, and Prognosis
The therapeutic approach to PDPH is divided into 4 stages: conservative management, aggressive medical management, conventional invasive treatments, and the very rarely employed less conventional invasive treatment and management algorithm to facilitate treatment is provided.
A study for post-diagnostic lumbar puncture headache in children
Post-diagnostic lumbar puncture headache in children was more common than other studies, and previous headache history and cell count in CSF are the factors that influence this occurrence.
Post-Dural Puncture Headache is Uncommon in Young Ambulatory Surgery Patients
There was a low overall incidence of post-dural puncture headache among patients aged 15–45 and pre-planned subgroup analyses of PDPH incidence by age group revealed a high risk of P DPH among a small sample of 15–19-year-olds.
A study for headaches and backaches occurrence after diagnostic lumbar puncture in children
Following lumbar puncture, headaches were common in patients over age 10, and lasted longer when the bevel orientation of the puncture needle was inserted toward the cranium rather than laterally.
Factors Predisposing to Post Dural Puncture Headache in Children
The risk factors for postdural puncture headache in a pediatric cohort varied from risk factors that are classically implicated in adults.


Headaches after diagnostic dural punctures
Aetiology of the headache from the dural puncture is most likely related to the hole left in the dura after the needle has been withdrawn, which allows the cerebrospinal fluid to leak out of the subarachnoid space, which depletes the “cushion” of fluid supporting the brain and its sensitive meningovascular covering, resulting in gravitational traction and the classic headache.
A rational approach to the cause, prevention and treatment of postdural puncture headache
The rate of PDPH after lumbar puncture can be minimized through strict attention to technique and the employment of a 25-gauge needle with the bevel parallel to the dural fibres.
Repeated Dural Punctures Increase the Incidence of Postdural Puncture Headache
It is concluded that increased risk of PDPH is a disadvantage of performing a second subarachnoid injection of local anesthetics after a failed spinal anesthetic, and this result suggests that leakage of CSF through the dural tear is the most plausible cause of P DPH.
Postdural Puncture Headache in Pediatric Oncology Patients
Children with a history of headache following a previous LP were nine times as likely to experience PDPH, a predisposing factor for development of postdural puncture headache in children after lumbar puncture.
Lumbar puncture needn't be a headache
Headache afterwards is the commonest complication, occurring in over 30% of patients when a 20 G bevelled needle is used, and usually lasts one to two days but may be more prolonged.
[Headaches after spinal anesthesia: prospective multicenter study of a young adult population].
The indications of spinal anaesthesia could be extended to young patients, whatever their gender, using a non-traumatic 24-gauge Sprotte needle, which was associated with a low rate of puncture difficulties.
Sprotte Needle for Obstetric Anesthesia: Decreased Incidence of Post Dural Puncture Headache
The data indicate that the Sprotte spinal needle, with its non-cutting tip, results in a significantly lower incidence of PDPH than Quincke cutting-tip needles of smaller gauge.
Post lumbar puncture headache: is bed rest essential?
Bed rest does not appear to alter the incidence of post lumbar puncture headaches, but reduces the severity in those who get headaches, after a lumbr puncture.
Incidence and Prediction of Postdural Puncture Headache A Prospective Study of 1021 Spinal Anesthesias
The estimated relation between postdural puncture headache and age and orientation of the bevel enables the anesthetist to predict the risk of PDPH and thereby to choose an acceptable age limit for spinal anesthesia.
Epidural blood patch for management of postdural puncture headache in adolescents
The aim of this survey was to review requests for EBPs and to evaluate the effectiveness of EBP in patients aged 13–18 years during a 6.5 year period ending in June 2001.