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Postdural puncture headache in pediatric oncology patients
C Ramamoorthy1, J M Geiduschek, S L Bratton
1Department of Anesthesiology, University of Washington School of Medicine, Children's Hospital and Medical Center, Seattle 98105, USA.
Insights
Postdural puncture headache (PDPH) occurred in 8% of children after lumbar puncture (LP). A history of prior headache significantly increased the risk of developing PDPH.
Area of Science:
- Pediatric Neurology
- Anesthesiology
- Neurosurgery
Background:
- Postdural puncture headache (PDPH) is a potential complication following lumbar puncture (LP).
- Understanding the incidence and risk factors for PDPH in pediatric populations is crucial for preventative strategies.
Purpose of the Study:
- To determine the incidence of PDPH in children undergoing LP.
- To identify risk factors associated with PDPH development in this age group.
Main Methods:
- A prospective cohort study enrolled 86 children undergoing LP.
- LPs were performed using 22-gauge spinal needles with a specific bevel orientation.
- Follow-up included telephone interviews and symptom diaries to diagnose PDPH.
Main Results:
- Six out of 80 children (8%) developed PDPH.
- PDPH incidence was 3% in children younger than 6 and 5% in those aged 6-12.
- Children with a prior history of headache after LP were nine times more likely to develop PDPH.
Conclusions:
- Postdural puncture headache is a notable complication in pediatric patients.
- A history of headache following a previous LP is a significant predisposing factor for PDPH.
Abstract:
This prospective cohort study determined the incidence and risk factors for development of postdural puncture headache (PDPH) in children after lumbar puncture (LP). Eighty-six children were enrolled. LPs were performed with use of 22-gauge spinal needles with the bevel oriented parallel to the long axis of the spine. Follow-up telephone interviews and patients' diary of symptoms were collected. Headache brought on by sitting up and relieved by lying down was defined as PDPH. Of the 80 who completed the study, six (8%) developed PDPH. Two (3%) were less than 6 years old and four (5%) were 6 to 12 years of age. Children with a history of headache following a previous LP were nine times as likely to experience PDPH. PDPH occurs not infrequently in children. A prior history of headache is a predisposing factor.