Frequency and severity of headache after lumbar myelography using a 25-gauge pencil-point (Whitacre) spinal needle

We studied 63 patients between the ages of 20 and 81 years undergoing lumbar myelography, using a 25-gauge pencil-point (Whitacre) spinal needle. With the use of a questionnaire, the incidence and severity of post-dural-puncture headache (PDPH) was investigated. There were three patients who complained of PDPH (4.7%), two of whom described their headache as moderate and one as mild on a visual analogue scale. All the headaches were alleviated by mild analgesics and no patient experienced severe headache needing treatment with a blood-patch. There were three other patients who experienced a post dural-puncture-related headache which, unlike PDPH, was not postural. Four patients had ordinary mild headache. The quality of the myelograms was good.