Post-dural puncture headache

Q: All of the following are associated with a post-lumbar puncture (LP) headache or more accurately a post-dural puncture headache (PDPH) except? 

A) Female gender 
B) Pregnancy 
C) History of prior headaches 
D) High opening pressure 
E) Low body mass index (BMI) 


 Answer: D

Contrary to popular belief, the lower the opening pressure during LP the higher the risk of PDPH, as there is more chance of cerebrospinal (CSF) fluid hypotension which subsequently causes venous dilatation/congestion, the actual reason behind a headache. 

#neurology


Reference:

Vilming ST, Schrader H, Monstad I. The significance of age, sex, and cerebrospinal fluid pressure in post-lumbar-puncture headache. Cephalalgia 1989; 9:99.