Rodriques Antonio Monteiro, Roy Pierre-Marie
Service d'accueil et traitement des urgences, centre hospitalier universitaire, Angers Cedex.
Rev Prat. 2007 Feb 28;57(4):353-7.
The postdural puncture headache is a frequent iatrogenic complication due to an excessive leakage of cerebrospinal fluid. The leak through the dural perforation mainly depends on the size and design of the needle. The diagnostic is based on the notion of dural puncture, headache worsening in upright posture and other symptoms as neck stiffness, tinnitus, hypacusia, photophobia or nausea. Symptoms resolve spontaneously within 1 week or within 48 hours after autologous epidural blood patch. Prevention is based on using small-gauge pencil-point needles whereas the duration of bed rest has no effect on the incidence of postlumbar puncture headache.
硬膜穿刺后头痛是一种常见的医源性并发症,原因是脑脊液过度渗漏。通过硬脊膜穿孔的渗漏主要取决于针的尺寸和设计。诊断基于硬膜穿刺的概念、直立姿势时头痛加重以及其他症状,如颈部僵硬、耳鸣、听力减退、畏光或恶心。症状会在1周内或自体硬膜外血贴后48小时内自行缓解。预防措施是使用小口径铅笔尖针,而卧床休息时间对腰穿后头痛的发生率没有影响。