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. 2013 Mar 5;80(10):941-8.
doi: 10.1212/WNL.0b013e3182840bf6. Epub 2013 Feb 6.

Postdural puncture headache in migraineurs and nonheadache subjects: a prospective study

W P J van Oosterhout  1 , A A van der Plas, E W van Zwet, R Zielman, M D Ferrari, G M Terwindt
Affiliations

Postdural puncture headache in migraineurs and nonheadache subjects: a prospective study

W P J van Oosterhout et al. Neurology. .

Abstract

Objectives: To prospectively assess 1) the incidence and duration of postdural puncture headache (PDPH) in migraineurs and healthy subjects; 2) the associated risk factors; and 3) the risk of getting a migraine attack shortly before or after lumbar puncture (LP).

Methods: As part of an extensive biochemical migraine research program, we assessed the occurrence, duration, and characteristics of PDPH in 160 migraineurs and 53 age- and sex-matched healthy controls. In addition, we evaluated potential risk factors for PDPH as well as the risk of developing a migraine attack before or after LP.

Results: In total, 64 of 199 subjects (32.2%) developed PDPH. Young age, low body mass index, severe headache immediately after LP, and sitting sampling position, but not being a migraineur, increased the risk of PDPH (all p < 0.05). Duration of PDPH was prolonged by history of depression, sitting sampling position, high perceived stress during the LP procedure, and multiple LP efforts (all p < 0.05). Migraine attacks were less likely to occur before or shortly after LP.

Conclusions: Migraineurs are not at increased risk of developing PDPH. PDPH duration is similar in migraineurs and age- and sex-matched controls. LP does not trigger migraine attacks, and the stress of an upcoming LP might even have a protective effect against onset of migraine attacks.

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Figures

Figure 1
Figure 1. Cumulative onset of postdural puncture headache (PDPH) in 64 subjects
Fifty-nine of 64 subjects (92.2%) reported PDPH <48 hours and 63 of 64 (98.4%) <72 hours after lumbar puncture (LP). Median time to onset was 20 hours.
Figure 2
Figure 2. Duration (days) of postdural puncture headache (PDPH) in 64 subjects with PDPH
See this image and copyright information in PMC

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