Lumber Puncture Headache

Lumber puncture is a frequently performed procedure in the ICUs. One of the nagging problem is post-lumbar puncture headache.

Lumbar puncture headache is believed to result from leakage and depletion of cerebrospinal fluid, causing traction on or distortion of anchoring pain-sensitive structures in the brain resulting in orthostatic headache. There may also be an effect of physical changes in the cerebral veins and venous sinuses.

Treatment options for post–lumbar puncture headache include hydration, caffeine, adrenocorticotropic hormone, sumatriptan, pregabalin, epidural saline, and epidural patches.

According to the results of a small study, IV theophylline promptly relieves the common problem of headache after lumbar puncture. In the study, mean pain scores were reduced by half within 30 minutes of treatment without adverse effects, researchers reported in a poster presentation at the 24th Meeting of the European Neurological Society (ENS).

Researchers administered theophylline, 200 mg in 100 mL of IV 5% dextrose, over 40 minutes. Patients in a sitting position reported pain on a 10-point visual analogue scale (VAS) at time 0 and at 30 and 60 minutes after the beginning of the infusion. All patients reported relief of pain at 30 and 60 minutes, with the greatest percentage decrease seen at 30 minutes.

 REFERENCES:

24th Meeting of the European Neurological Society (ENS): Abstract PP1104. Presented May 31, 2014.