Post-Lumbar Puncture Headache—Does Hydration before Puncture Prevent Headache and Affect Cerebral Blood Flow?

Journal of Clinical Medicine

Beata Kukulska-Pawluczuk¹  Henryk Kaźmierczak²  Magdalena Nowaczewska³  Katarzyna Pawlak-Osińska³ 

[1] Department of Neurology, Ludwig Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;Department of Pathophysiology of Hearing and Balance, Ludwig Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;

关键词: cerebral hemodynamics;    cerebral blood flow;    transcranial doppler;    neurosonology;    post-lumbar puncture headache;    flow velocity;    intracranial pressure;    pulsatility index;    hydration;    fluid;    intracranial hypotension;   

DOI  :  10.3390/jcm8101710

来源: DOAJ

【 摘 要 】

Headache is a common complication after diagnostic lumbar puncture (DLP). We aimed to check whether hydration before puncture influences the incidence of post-lumbar puncture headache (PLPH) and affects cerebral blood flow. Ninety-nine patients enrolled for puncture were assigned to a group with (n = 40) or without hydration (n = 59). In the hydration group, 1000 mL 0.9% NaCl was infused and a minimum of 1500 mL oral fluids was recommended within the 24 h before puncture. A Transcranial Doppler (TCD) was performed before and after DLP. Mean velocity (Vm) and pulsatility index (PI) were measured in the middle cerebral arteries (MCAs). PLPH occurred in 28 patients (28.2%): six (15.4%) from the hydrated and 22 (37.3%) from the non-hydrated group (p < 0.023). Patients with PLPH were younger (p < 0.014) and with headaches in their histories (p < 0.036) compared with the non-headache group. Vm values in both MCAs after puncture were significantly lower than before puncture in all patients. In the PLPH group, Vm in MCAs before puncture were significantly higher and the PI was lower than in the non-headache group. Our findings suggest that hydration of patients within 24 h before puncture prevented PLPH. Twenty-four hours after puncture, significant decreases in Vm were observed in the MCAs of all patients. Low baseline values of PI and high Vm predisposed patients to PLPH.

【 授权许可】

Unknown